Taurolidine: A Comprehensive Monograph on its Pharmacology, Clinical Efficacy, and Therapeutic Applications

Section 1: Introduction and Chemical Profile

1.1. Overview and Historical Context

Taurolidine is a synthetic small molecule antimicrobial agent derived from the naturally occurring amino acid, taurine.[1] First synthesized in the 1970s, its development marked the introduction of a novel therapeutic agent with a unique mechanism of action distinct from conventional antibiotics.[1] The initial clinical application of taurolidine was as a prophylactic agent for the prevention and treatment of intraperitoneal bacterial infections, particularly in patients with peritonitis, where it was often used as a surgical lavage solution.[1] This early use established its reputation as a potent, broad-spectrum antimicrobial with a favorable safety profile in local applications.

Over the subsequent decades, the clinical utility of taurolidine has evolved significantly. Recognizing its ability to prevent the formation of microbial biofilms and its low propensity for inducing bacterial resistance, its application shifted towards the prevention of catheter-related infections, a major source of morbidity and mortality in patients requiring long-term vascular access.[7] This has become its primary and most well-established therapeutic role, culminating in its approval in various formulations worldwide for use as a catheter lock solution.[1] Concurrently, research beginning in the late 1990s uncovered potent antineoplastic properties, sparking a parallel line of investigation into its potential as a cancer therapeutic.[2] This dual identity—as both an established anti-infective and an investigational anti-cancer agent—makes taurolidine a subject of considerable scientific and clinical interest.

1.2. Nomenclature, Identification, and Structural Classification