ABSTRACT. Device-associated infections are serious complications, and their prevention is an issue of considerable importance. Since biofilms are responsible for these refractory infections, effective methods to inhibit biofilm formation are required. In this investigation, stainless steel plates with and without 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer, i.e., poly (MPC-co-n-butyl methacrylate) (PMB) coating, were incubated in a medium containing bacteria. In the course of incubation, half of the specimens received antibiotics. The specimens were stained for nucleic acid and polysaccharides, and then examined with a confocal laser scanning microscope. The numbers of bacteria on the specimen surfaces were evaluated by an ATP assay. On the surfaces of the specimens without PMB coating, the formation of a biofilm enveloping bacteria was confirmed. The addition of antibiotics did not effectively decrease the number of bacteria. On the other hand, on the surfaces of the specimens with PMB coating, no biofilm formation was observed, and the number of bacteria was significantly decreased. The addition of potent antibiotics further decreased the number of bacteria by 1/100 to 1/1000 times. The PMB coating combined with the validated use of antibiotics might provide a method for the simultaneous achievement of biocompatible surfaces of devices and the prevention of device-associated infections. KEY WORDS: biofilm, biomaterials, device-associated infection, MPC, PMB coating.Device-associated infections are serious complications in patients receiving indwelling catheters. These complications, however, do not limited in such cases; device-associated infections are consistent risk accompanying the usage of any artificial devices. For instance, applications of bone fixation plates to open fractures are contraindicated. Actually, the rate of the infections was reported to be as high as 15% to 18% [23] if an aseptic condition was not maintained during the treatment. Although the microorganisms responsible for these infections are usually indigenous bacteria such as Staphylococcus epidermidis, a difficulty arises as antibacterial agents are not effective against these infections. Once the infections are established, persistent inflammations continue as long as the devices remain in the body.Device-associated infections are caused by bacteria that adhere to the surfaces of internal prosthetic devices and are thought to develop through the following sequence of events [3,7,10,18,22]. Immediately after the implantation of devices into patients, various molecules such as peptides and proteins are adsorbed onto the surfaces of the materials. These molecules mediate the attachment of bacteria. Once the bacteria, e.g., those belonging to the species S. epidermidis, are attached to the surfaces of devices, they proliferate and aggregate there to form biofilms in which the bacteria are enveloped in a thin layer of polysaccharides. The bacteria in the biofilms are protected from the biological defense mechanism, including ph...