The rapid, broad-spectrum, biofilm eradicating activity of the combination 0.01% nitroglycerin, 7% citrate and 20% ethanol and its potential as a non-antibiotic, antimicrobial catheter lock solution (ACLS) was previously reported” Reitzel et al (2016).
The rapid, broad-spectrum, biofilm eradicating activity of the combination 0.01% nitroglycerin, 7% citrate and 20% ethanol and its potential as a non-antibiotic, antimicrobial catheter lock solution (ACLS) was previously reported. Here a Nitroglycerin-Citrate-Ethanol (NiCE) ACLS optimized for clinical assessment was developed by reducing nitroglycerin and citrate concentrations and increasing ethanol concentration.
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Biofilm eradicating activity was sustained when the ethanol concentration was increased from 20 to 22% and fully compensated for reducing the citrate concentration from 7% to 4% as well as the nitroglycerin concentration from 0.01% to 0.0015% or 0.003%. The optimized formulations demonstrated complete and rapid (2 hr) eradication of MRSA, VISA, MRSE, VRE, multi-drug resistant (MDR) Pseudomonas aeruginosa, MDR Klebsiella pneumoniae, MDR Enterobacter cloacae, MDR Acinetobacter baumannii, MDR Escherichia coli, MDR Stenotrophomonas maltophilia, Candida albicans, and Candida glabrata biofilms. The optimized NiCE lock solutions demonstrated anticoagulant activity comparable to heparin lock solutions. When compared to Taurolidine-Citrate-Heparin lock solution, NiCE was significantly more effective in eradicating biofilms of Staphylococcus aureus and Candida glabarata The optimized, non-antibiotic, heparin-free NiCE lock solution demonstrates rapid broad-spectrum biofilm eradication as well as effective anticoagulant activity making NiCE a high-quality ACLS candidate for clinical assessment.
Reitzel, R.A., Rosenblatt, J., Hirsh-Ginsberg, C., Murray, K., Chaftari, A.M., Hachem, R. and Raad, I. (2016) Optimized Nitroglycerin-Citrate-Ethanol (NiCE), non-antibiotic, antimicrobial, catheter lock solution for prevention of central line associated blood stream infections (CLABSI) – an in vitro assessment of antimicrobial efficacy. Antimicrobial Agents and Chemotherapy. June 13th. [Epub ahead of print].
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