Medical device with multi-layer coating incorporating cationic steroidal antimicrobials

An implantable medical device configured to elute one or more cationic steroidal antimicrobial (CSA) compounds, comprising:

• a base substrate forming at least a portion of the implantable medical device;
• a multi-layered coating disposed on the base substrate, the multi-layered coating comprising
• (i) a CSA coating layer disposed over the base substrate, the CSA coating layer comprising a polymer in which one or more CSA compounds are distributed, and
• (ii) a top coating layer disposed over the CSA coating layer, the top coating layer being free of CSA compounds,
• wherein when the implantable medical device is exposed to a physiological environment, the top coating layer provides
• (i) more sustained elution of the one or more CSA compounds, as compared to the implantable medical device without the top coating layer, and/or
• (ii) reduced swelling of the CSA coating layer, as compared to the implantable medical device without the top coating layer.