Compositions and methods for coating medical implants

Abstract

Medical implants are provided which release an anthracycline, fluoropyrimidine, folic acid antagonist, podophylotoxin, camptothecin, hydroxyurea, and/or platinum complex, thereby inhibiting or reducing the incidence of infection associated with the implant.

1 .- 23 . (canceled) 
     
     
         24 . A method for reducing or inhibiting fungal infection associated with a medical implant, comprising:
 introducing into a patient a medical implant that comprises (a) a therapeutic agent, or (b) a composition that comprises a therapeutic agent,   wherein the therapeutic agent is an anthracycline, fluoropyrimidine, folic acid antagonist, podophylotoxin, camptothecin, hydroxyurea, platinum complex, or a combination thereof, and wherein the therapeutic agent is in an amount effective to reduce or inhibit fungal growth on the medical implant.   
     
     
         25 . The method according to  claim 24 , wherein the medical implant is covered or coated in whole or in part with a composition comprising an anthracycline, fluoropyrimidine, folic acid antagonist, podophylotoxin, camptothecin, hydroxyurea, or platinum complex. 
     
     
         26 . The method according to  claim 24 , wherein the therapeutic agent is a fluoropyrimidine. 
     
     
         27 . The method according to  claim 26 , wherein the fluoropyrimidine is 5-fluorouracil. 
     
     
         28 . The method according to  claim 26 , wherein the implant comprises 0.1 μg to 250 mg fluoropyrimidine. 
     
     
         29 . The method according to  claim 26 , wherein the implant comprises 0.1 μg to 1 mg fluoropyrimidine per mm 2  of surface area of the portion of the medical implant to which the fluoropyrimidine is applied or incorporated. 
     
     
         30 . The method according to  claim 24 , wherein the medical implant releases the therapeutic agent in concentrations effective to reduce or inhibit fungal growth on the medical implant for a period ranging form 1-30 days. 
     
     
         31 . The method according to  claim 24  wherein the composition comprises one or more polymers. 
     
     
         32 . The method according to  claim 31  wherein the composition comprises one or more non-biodegradable polymers. 
     
     
         33 . The method according to  claim 32 , wherein the non-biodegradable polymer is selected from polyurethanes, acrylic or methacrylic copolymers, cellulose or cellulose-derived polymers, and blends thereof. 
     
     
         34 . The method according to  claim 33 , wherein the polyurethane is a poly(carbonate urethane), poly(ester urethane) or poly(ether urethane). 
     
     
         35 . The method according to  claim 33 , wherein the cellulose-derived cellulose is selected from nitrocellulose, cellulose acetate butyrate, and cellulose acetate propionate. 
     
     
         36 . The method according to  claim 31 , wherein the composition comprises one or more biodegradable polymers. 
     
     
         37 . The method according to  claim 24 , wherein the medical implant is a catheter. 
     
     
         38 . The method according to  claim 37 , wherein the catheter is a vascular access catheter. 
     
     
         39 . The method according to  claim 37 , wherein the catheter is a central venous catheter. 
     
     
         40 . The method according to  claim 37 , wherein the catheter is a peripheral venous catheter. 
     
     
         41 . The method according to  claim 37 , wherein the catheter is a vascular infusion catheter. 
     
     
         42 . The method according to  claim 37 , wherein the catheter is a hemodialysis catheter. 
     
     
         43 . The method according to  claim 37 , wherein the catheter is a peritoneal dialysis catheter. 
     
     
         44 . The method according to  claim 37 , wherein the catheter is a chronic dwelling gastrointestinal catheter, chronic dwelling genitourinary catheter, or urinary catheter. 
     
     
         45 . The method according to  claim 24 , wherein the medical implant is an arterial line. 
     
     
         46 . The method according to  claim 24 , wherein the medical implant is selected from endotracheal tubes, tracheostomy tubes, feeding tubes, central nervous shunts, portosystemic shunts, shunts for ascites, tympanostomy tubes, drainage tubes, biliary tubes, conduits, nasogastric tubes, and percutaneous feeding tubes. 
     
     
         47 . The method according to  claim 24 , wherein the medical implant is a pump, a venous port, a chronic infusion port, a vascular graft, a cardiac pacemaker, an implantable cardioverter defibrillator, an orthopedic implant, a urological implant, a prosthetic heart valve, an ocular implant, an ear, nose, or throat implant, a cardiac pacemaker lead, a neurological or neurosurgical device, a gastrointestinal device, a genitourinary device, an opthalmological implant, a plastic surgery implant, or a catheter cuff. 
     
     
         48 . The method of  claim 37 , wherein the catheter is composed of polyurethane. 
     
     
         49 . The method of  claim 24 , wherein the medical implant further comprises a second anti-infective agent, an antithrombotic agent or an antiplatelet agent. 
     
     
         50 . The method of  claim 49 , wherein the antithrombotic agent or the antiplatelet agent is selected from heparin, dextran sulphate, danaparoid, lepirudin, hirudin, AMP, adenosine, 2-chloroadenosine, aspirin, phenylbutazone, indomethacin, meclofenamate, hydrochloroquine, dipyridamole, iloprost, ticlopidine, clopidogrel, abcixamab, eptifibatide, tirofiban, streptokinase, and/or tissue plasminogen activator.