Abstract

Urinary catheters (UCs) are critical in biomedical applications, but prolonged use increases the risk of catheter-associated urinary tract infections (CAUTIs), a leading cause of healthcare-associated infections (HAIs). The present study presents a dual strategy to create an antibacterial surface on commercial Foley silicone UCs by combining a contact-killing effect with the controlled release of antimicrobial compounds. We designed a drug delivery system using a layer-by-layer (LbL) antibacterial coating of carboxymethylcellulose (CMC) and chitosan-silver (CHI-Ag) complexes, with ciprofloxacin (CFX) as the model drug. The resulting LbL coating, about 1 (Formula presented.) thick, incorporated (Formula presented.) and demonstrated a high capacity for CFX loading, releasing over twice the amount ((Formula presented.)) compared to uncoated UCs ((Formula presented.)). The antibacterial efficacy was significantly higher in the LbL-coated samples, particularly against S. aureus compared to E. coli. Drug release experiments, modeled using Fick’s second law, indicated a diffusivity of (Formula presented.). Our mathematical model predicts how variations in drug loading and rest times impact release profiles. Finally, molecular dynamics simulations suggested strong compatibility between CFX and the LbL layers, though with relatively low stability. This dual strategy holds promise for reducing CAUTIs effectively. Copyright © 2025 Pulido, Naveas, Fernández-Alonso, Manso-Silván, Soriano, Torres-Ulloa, Mena-Ulecia, Recio-Sánchez, Garcia-Sandoval and Hernández-Montelongo.