*2.1. BMAP-28*

BMAP-28 is a 27 residue peptide. It has an amidated C-terminus, and it has been shown to have the ability to kill bacteria in vitro. Furthermore, in vivo studies have also demonstrated BMAP-28 efficacy in reducing mortality in different infections [17,18].

Cirioni et al. (2005) assessed the efficacy of BMAP-28 pre-coating in the treatment of *S. aureus* central venous catheter-associated infections using the antibiotic-lock technique. In vitro studies revealed that pretreatment with BMAP-28 and then the use of antibiotics reduced the Minimal Bactericidal Concentration (MBC) values against biofilm. In vivo studies demonstrated that catheters pre-treated with BMAP-28 or high-dose antibiotics have a lower bacterial load compared to catheters with standard-dose antibiotics or without BMAP-28 (from 10<sup>7</sup> to 10<sup>3</sup> CFU/mL and bacteremia from 103 to 10<sup>1</sup> CFU/mL). A further significant reduction in bacterial load, from 107 to 10<sup>1</sup> CFU/mL, was observed when catheters were impregnated with BMAP-28 and then treated with a higher dose of antibiotics [19].

Another experimental study was performed to evaluate the efficacy of BMAP-28. In particular, the efficacy of BMAP-28 alone and in combination with vancomycin was assessed in animal models of ureteral stent infection induced by *Enterococcus faecalis* and *Staphylococcus aureus*. In vivo studies revealed that BMAP-28 reduced bacterial load (from <sup>8</sup> × <sup>10</sup><sup>6</sup> to 5 × <sup>10</sup><sup>4</sup> against *S. aureus* and from 8.7 × 106 to 6.4 × 104 against *E. faecalis*) and enhanced the effect of vancomycin (no bacterial count). This result suggests that the BMAP-28-impregnated ureteral stent has lower rates of infection. In vitro studies support these results [20].
