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Updated: Jun 26, 2026
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A Novel Method to Determine the Longitudinal Antibacterial Activity of Drug-Eluting Materials
Published on: March 3, 2023
Antibacterial activity of epidural infusions
M W Coghlan1, M J Davies, C Hoyt
1Department of Anaesthesia, St Vincent's Hospital, Melbourne, Victoria, Australia.
Anaesthesia and Intensive Care
|January 23, 2009
Summary
Bupivacaine demonstrated antibacterial properties against common bacteria, unlike levobupivacaine and ropivacaine. Higher bupivacaine concentrations may reduce the risk of epidural abscesses.
Area of Science:
- Anesthesiology
- Microbiology
- Infectious Disease
Background:
- Epidural abscess incidence is rising, with recent reports indicating one in 1000 surgical patients.
- Epidural catheterization is a common procedure, necessitating an understanding of associated infection risks.
Purpose of the Study:
- To investigate the antibacterial activity of local anesthetics and additives used in epidural infusions.
- To identify epidural infusion solutions with the greatest potential to inhibit microbial growth associated with epidural abscesses.
Main Methods:
- Agar dilution method to determine minimum inhibitory concentrations (MICs) for bacteria.
- Tested bupivacaine, ropivacaine, and levobupivacaine at various concentrations (0.06%–1%).
- Evaluated the impact of fentanyl, adrenaline, and clonidine, alone and in combination with local anesthetics.
Main Results:
- Bupivacaine exhibited antibacterial activity against Staphylococcus aureus, Enterococcus faecalis, and Escherichia coli (MICs 0.125%–0.25%).
- Levobupivacaine and ropivacaine showed minimal to no activity against tested bacteria, including Pseudomonas aeruginosa.
- Fentanyl, adrenaline, and clonidine did not enhance the antibacterial effects of the local anesthetics.
Conclusions:
- Standard epidural infusion concentrations of local anesthetics possess limited antibacterial activity.
- Increasing bupivacaine concentration or administering a daily bolus may be considered to mitigate the risk of bacterial growth in epidural infusions.
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