# US 9,433,209 B2 · Transdermal venous access locking solutions

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- Number: US 9,433,209 B2
- Document ID: US9433209B2
- Status: Granted
- Kind: B2
- Application number: 14/698,268
- Filed: 2015-04-28
- Published: 2015-08-27
- Granted: 2016-09-06
- Earliest claimed: 2009-03-26
- Applicants: Organic Medical Ventures, L.L.C.
- Inventors: Stanley L. Mills; Jacqueline L. Mills; Robert D. Maurer; Gary L. Rayburn; Marvin A. Cuchens
- Web page: https://patentgrep.com/patent/US9433209B2

## CPC

- A01N 37/02: Saturated carboxylic acids or thio analogues thereof; Derivatives thereof
- A61J 1/05: for collecting, storing or administering blood, plasma or medical fluids {(multiple bags systems for separating or storing blood components A61M1/0209); Infusion or perfusion containers}
- A61K 31/095: Sulfur, selenium, or tellurium compounds, e.g. thiols
- A61K 31/132: having two or more amino groups, e.g. spermidine, putrescine
- A61K 31/16: Amides, e.g. hydroxamic acids
- A61K 31/194: having two or more carboxyl groups, e.g. succinic, maleic or phthalic acid
- A61K 31/195: having an amino group
- A61K 31/198: Alpha-amino acids, e.g. alanine or edetic acid [EDTA] (betaine A61K31/205; proline A61K31/401; tryptophan A61K31/405; histidine A61K31/4172; peptides not degraded to individual amino acids A61K38/00)
- A61K 31/20: having a carboxyl group bound to a chain of seven or more carbon atoms, e.g. stearic, palmitic, arachidic acids
- A61K 31/29: Antimony or bismuth compounds
- A61K 31/315: Zinc compounds
- A61K 31/663: Compounds having two or more phosphorus acid groups or esters thereof, e.g. clodronic acid, pamidronic acid
- A61K 31/727: Heparin; Heparan
- A61K 45/06: Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
- A61L 29/14: Materials characterised by their function or physical properties {, e.g. lubricating compositions}
- A61L 29/16: Biologically active materials, e.g. therapeutic substances {(A61L29/048 takes precedence)}
- B65D 81/32: for packaging two or more different materials which must be maintained separate prior to use in admixture
- B65D 85/70: {for materials not otherwise provided for}
- A61L 2300/216: with other specific functional groups, e.g. aldehydes, ketones, phenols, quaternary phosphonium groups
- A61L 2300/404: Biocides, antimicrobial agents, antiseptic agents
- A61M 25/0017: {specially adapted for long-term hygiene care, e.g. urethral or indwelling catheters to prevent infections}
- A61M 25/0045: {multi-layered, e.g. coated (coating materials A61L29/08)}
- A61M 39/0247: {Transcutaneous or percutaneous access sites to the inside of the body}
- A61M 2025/0019: {Cleaning catheters or the like, e.g. for reuse of the device, for avoiding replacement}
- A61M 2025/0056: {provided with an antibacterial agent, e.g. by coating, residing in the polymer matrix or releasing an agent out of a reservoir}
- A61M 2039/0258: {for vascular access, e.g. blood stream access}
- A01N: PRESERVATION OF BODIES OF HUMANS OR ANIMALS OR PLANTS OR PARTS THEREOF (preservation of food or foodstuff A23); BIOCIDES, e.g. AS DISINFECTANTS, AS PESTICIDES OR AS HERBICIDES (preparations for medical, dental or toiletry purposes which kill or prevent the growth or proliferation of unwanted organisms A61K); PEST REPELLANTS OR ATTRACTANTS; PLANT GROWTH REGULATORS
- A61J: CONTAINERS SPECIALLY ADAPTED FOR MEDICAL OR PHARMACEUTICAL PURPOSES; DEVICES OR METHODS SPECIALLY ADAPTED FOR BRINGING PHARMACEUTICAL PRODUCTS INTO PARTICULAR PHYSICAL OR ADMINISTERING FORMS; DEVICES FOR ADMINISTERING FOOD OR MEDICINES ORALLY; BABY COMFORTERS; DEVICES FOR RECEIVING SPITTLE
- A61K: PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES (devices or methods specially adapted for bringing pharmaceutical products into particular physical or administering forms A61J3/00; chemical aspects of, or use of materials for deodorisation of air, for disinfection or sterilisation, or for bandages, dressings, absorbent pads or surgical articles A61L; soap compositions C11D)
- A61L: METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES (preservation of bodies or disinfecting characterised by the agents employed A01N; preserving, e.g. sterilising, food or foodstuffs A23; preparations for medical, dental or toiletry purposes A61K)
- B65D: CONTAINERS FOR STORAGE OR TRANSPORT OF ARTICLES OR MATERIALS, e.g. BAGS, BARRELS, BOTTLES, BOXES, CANS, CARTONS, CRATES, DRUMS, JARS, TANKS, HOPPERS, FORWARDING CONTAINERS; ACCESSORIES, CLOSURES, OR FITTINGS THEREFOR; PACKAGING ELEMENTS; PACKAGES
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}

## Abstract

Microbial growth inhibiting solutions and methods of employing the microbial growth inhibiting solutions in flushing and coating medical devices are disclosed. In alternative embodiments, the microbial growth inhibiting solutions include combinations of a chelating agent with a C4-C9, C10 or C12 carboxylate antimicrobial agent, for example, such as n-capric, n-lauric, or n-octanoic acid. Methods of using these microbial growth inhibiting solutions for coating a medical device and for inhibiting catheter infection are also disclosed.

## Claims

### Claim 1

A microbial growth inhibiting solution comprising a C10 or C12 carboxylate antimicrobial agent and an agent that is a chelator and a buffer, wherein the C10 or C12 carboxylate antimicrobial agent is present in an amount ranging from about 0.05 mg/mL to about 5 mg/mL, wherein the agent that is a chelator and a buffer is citrate and is present in an amount ranging from about 1 mg/mL to about 200 mg/mL, and wherein the solution has a pH of 5.2 or less.

### Claim 2 (depends on 1)

The microbial growth inhibiting solution of claim 1 further comprising an additional chelating agent selected from the group consisting of ethylenediaminetetraacetic acid, diethylenetriamine pentaacetic acid, ethylene glycol tetraacetic acid, etidronate, dimercaptosuccinic acid, deferoxamine, dimercaprol, triethylene tetramine dihydrochloride, zinc citrate, combination of bismuth and citrate, penicillamine, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 3 (depends on 2)

The microbial growth inhibiting solution of claim 2, wherein the additional chelating agent chelates Ca, Mg, Mn, Fe or Zn.

### Claim 4 (depends on 2)

The microbial growth inhibiting solution of claim 2, wherein the additional chelating agent is present in an amount ranging from about 0.1 mg/mL to about 2 mg/mL.

### Claim 5 (depends on 2)

The microbial growth inhibiting solution of claim 2, wherein the additional chelating agent is present in an amount ranging from about 0.25 mg/mL to about 0.5 mg/mL.

### Claim 6 (depends on 1)

The microbial growth inhibiting solution of claim 1, wherein the C12 carboxylate antimicrobial agent is selected from the group consisting of:
agents having the formula R—COOH wherein R=C9 or C11 n-alkyl, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 7 (depends on 1)

The microbial growth inhibiting solution of claim 1, wherein the C10 or C12 carboxylate antimicrobial agent is selected from the group consisting of n-lauric acid, a pharmaceutically acceptable salt thereof and combinations thereof.

### Claim 8 (depends on 1)

The microbial growth inhibiting solution of claim 1 further comprising a pharmacologically acceptable carrier solution.

### Claim 9 (depends on 8)

The microbial growth inhibiting solution of claim 8, wherein the pharmacologically acceptable carrier solution comprises saline, Ringer's solution, or water pH adjusted to 5.2 or less.

### Claim 10 (depends on 1)

The microbial growth inhibiting solution of claim 1 further comprising an additional chelating agent present in an amount ranging from about 0.1 mg/mL to about 2 mg/mL wherein the C10 or C12 carboxylate antimicrobial agent is present in an amount ranging from about 0.071 mg/mL to about 1.15 mg/mL.

### Claim 11 (depends on 10)

The microbial growth inhibiting solution of claim 10, wherein the C10 or C12 carboxylate antimicrobial agent comprises sodium caprate or sodium laurate and the additional chelating agent comprises disodium ethylenediaminetetraacetic acid.

### Claim 12

A method of disinfecting an implanted catheter from bacteria and fungi, the method comprising:
introducing to a lumen of a catheter a microbial growth inhibiting solution comprising a C10 or C12 carboxylate antimicrobial agent and a chelating agent, wherein the C10 or C12 carboxylate antimicrobial agent is present in an amount ranging from about 0.05 mg/mL to about 5 mg/mL and the chelating agent is present in an amount ranging from about 0.01 mg/mL to about 2 mg/mL, and wherein the solution has a pH of 5.2 or less.

### Claim 13 (depends on 12)

The method of claim 12, wherein at least a portion of the catheter is sufficiently porous to permit diffusion of the solution outwardly from the lumen to the outer surface of the catheter and into tissues or the bloodstream surrounding the catheter to inhibit infection.

### Claim 14 (depends on 12)

The method of claim 12, wherein the C10 or C12 carboxylate antimicrobial agent is selected from the group consisting of:
agents having the formula R—COOH wherein R=C9 or C11 n-alkyl, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 15 (depends on 12)

The method of claim 12, wherein the C10 or C12 carboxylate antimicrobial agent is selected from the group consisting of n-capric acid, n-lauric acid, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 16 (depends on 12)

The method of claim 12, wherein the chelating agent is selected from the group consisting of ethylenediaminetetraacetic acid, diethylenetriamine pentaacetic acid, ethylene glycol tetraacetic acid, etidronate, dimercaptosuccinic acid, deferoxamine, dimercaprol, triethylene tetramine dihydrochloride, zinc citrate, combination of bismuth and citrate, penicillamine, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 17 (depends on 12)

The method of claim 12, wherein the microbial growth inhibiting solution further comprises a buffer present in an amount ranging from about 1.5 to about 24 mM, wherein the C10 or C12 carboxylate antimicrobial agent is present in an amount ranging from about 0.071 mg/mL to about 1.15 mg/mL, and the chelating agent is present in an amount ranging from about 0.0625 mg/mL to about 1 mg/mL.

### Claim 18 (depends on 17)

The method of claim 17, wherein the C10 or C12 carboxylate antimicrobial agent comprises sodium caprate or socium laurate, the buffer comprises citrate, and the chelating agent comprises disodium ethylenediaminetetraacetic acid.

### Claim 19

A method for coating a medical device, the method comprising:
exposing the medical device to a microbial growth inhibiting solution for a sufficient amount of time to provide a coating on the exposed surface of the device, wherein the microbial growth inhibiting solution comprises a C10 or C12 carboxylate antimicrobial agent and a chelating agent, wherein the C10 or C12 carboxylate antimicrobial agent is present in an amount ranging from about 0.05 mg/mL to about 5 mg/mL and the chelating agent is present in an amount ranging from about 0.01 mg/mL to about 2 mg/mL, and wherein the solution has a pH of 5.2 or less.

### Claim 20 (depends on 19)

The method of claim 19 further comprising treating the device with a surfactant before exposing the device to the microbial growth inhibiting solution.

### Claim 21 (depends on 20)

The method of claim 20, wherein the surfactant is selected from the group of surfactant consisting of tridodecylmethyl ammonium chloride, benzalkonium chloride and combinations thereof.

### Claim 22 (depends on 19)

The method of claim 19, wherein the C10 or C12 carboxylate antimicrobial agent is selected from the group consisting of:
agents having the formula R—COOH wherein R=C9 or C11 n-alkyl, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 23 (depends on 19)

The method of claim 19, wherein the C10 or C12 carboxylate antimicrobial agent is selected from the group consisting of n-capric acid, n-lauric acid, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 24 (depends on 19)

The method of claim 19, wherein the chelating agent is present in an amount ranging from about 0.1 mg/mL to about 1 mg/mL and is selected from the group consisting of ethylenediaminetetraacetic acid, diethylenetriamine pentaacetic acid, ethylene glycol tetraacetic acid, etidronate, dimercaptosuccinic acid, deferoxamine, dimercaprol, triethylene tetramine dihydrochloride, zinc citrate, combination of bismuth and citrate, penicillamine, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 25 (depends on 19)

The method of claim 19, wherein the chelating agent is present in an amount ranging from about 0.25 mg/mL to about 0.5 mg/mL and is selected from the group consisting of ethylenediaminetetraacetic acid, diethylenetriamine pentaacetic acid, ethylene glycol tetraacetic acid, etidronate, dimercaptosuccinic acid, deferoxamine, dimercaprol, triethylene tetramine dihydrochloride, zinc citrate, combination of bismuth and citrate, penicillamine, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 26 (depends on 19)

The method of claim 19, wherein the microbial growth inhibiting solution further comprises a buffer present in an amount ranging from about 1.5 to about 24 mM, wherein the C10 or C12 carboxylate antimicrobial agent is present in an amount ranging from about 0.071 mg/mL to about 1.15 mg/mL, and the chelating agent is present in an amount ranging from about 0.0625 mg/mL to about 1 mg/mL.

### Claim 27 (depends on 26)

The method of claim 26, wherein the C10 or C12 carboxylate antimicrobial agent comprises sodium caprate or socium laurate, the buffer comprises citrate, and the chelating agent comprises disodium ethylenediaminetetraacetic acid.

### Claim 28

A medical device coated with a microbial growth inhibiting solution comprising a C10 or C12 carboxylate antimicrobial agent and a chelating agent, wherein the C10 or C12 carboxylate antimicrobial agent is present in an amount ranging from about 0.05 mg/mL to about 5 mg/mL and the chelating agent is present in an amount ranging from about 0.01 mg/mL to about 2 mg/mL, and wherein the solution has a pH of 5.2 or less.

### Claim 29 (depends on 28)

The medical device of claim 28, wherein the medical device is selected from the group of devices consisting of a central venous catheter, a peripheral intravenous catheter, an arterial catheter, a Swant-Ganz catheter, a hemodialysis catheter, an umbilical catheter, a percutaneous nontunneled silicone catheter, a cuffed tunneled central venous catheter and a subcutaneous central venous pert.

### Claim 30 (depends on 28)

The medical device of claim 28, wherein the C10 or C12 carboxylate antimicrobial agent is selected from the group consisting of:
agents having the formula R—COOH wherein R=C9 or C11 n-alkyl, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 31 (depends on 28)

The medical device of claim 28, wherein the C10 or C12 carboxylate antimicrobial agent is selected from the group consisting of n-capric acid, n-lauric acid, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 32 (depends on 28)

The medical device of claim 28, wherein the chelating agent is present in an amount ranging from about 0.1 mg/mL to about 1 mg/mL and is selected from the group consisting of ethylenediaminetetraacetic acid, diethylenetriamine pentaacetic acid, ethylene glycol tetraacetic acid, etidronate, dimercaptosuccinic acid, deferoxamine, dimercaprol, triethylene tetramine dihydrochloride, zinc citrate, combination of bismuth and citrate, penicillamine, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 33 (depends on 28)

The medical device of claim 28, wherein the chelating agent is present in an amount ranging from about 0.25 mg/mL to about 0.5 mg/mL and is selected from the group consisting of ethylenediaminetetraacetic acid, diethylenetriamine pentaacetic acid, ethylene glycol tetraacetic acid, etidronate, dimercaptosuccinic acid, deferoxamine, dimercaprol, triethylene tetramine dihydrochloride, zinc citrate, combination of bismuth and citrate, penicillamine, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 34 (depends on 28)

The medical device of claim 28, wherein the microbial growth inhibiting solution further comprises a buffer present in an amount ranging from about 1.5 to about 24 mM, wherein the C10 or C12 carboxylate antimicrobial agent is present in an amount ranging from about 0.071 mg/mL to about 1.15 mg/mL, and the chelating agent is present in an amount ranging from about 0.0625 mg/mL to about 1 mg/mL.

### Claim 35 (depends on 34)

The medical device of claim 34, wherein the C10 or C12 carboxylate antimicrobial agent comprises sodium caprate or socium laurate, the buffer comprises citrate, and the chelating agent comprises disodium ethylenediaminetetraacetic acid.

### Claim 36

A method for locking and/or flushing an implanted catheter, the method comprising:
filling a lumen of an implanted catheter open to a body lumen with a microbial growth inhibiting solution comprising a C10 or C12 carboxylate antimicrobial agent and a chelating agent, wherein the C10 or C12 carboxylate antimicrobial agent is present in an amount ranging from about 0.05 mg/mL to about 5 mg/mL and the chelating agent is present in an amount ranging from about 0.01 mg/mL to about 2 mg/mL, and wherein the solution has a pH of 5.2 or less.

### Claim 37 (depends on 36)

The method of claim 36, wherein the C10 or C12 carboxylate antimicrobial agent is selected from the group consisting of:
agents having the formula R—COOH wherein R=C9 or C11 n-alkyl, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 38 (depends on 36)

The method of claim 36, wherein the C10 or C12 carboxylate antimicrobial agent is selected from the group consisting of n-capric acid, n-lauric acid, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 39 (depends on 36)

The method of claim 36, wherein the chelating agent is present in an amount ranging from about 0.1 mg/mL to about 1 mg/mL and is selected from the group consisting of ethylenediaminetetraacetic acid, diethylenetriamine pentaacetic acid, ethylene glycol tetraacetic acid, etidronate, dimercaptosuccinic acid, deferoxamine, dimercaprol, triethylene tetramine dihydrochloride, zinc citrate, combination of bismuth and citrate, penicillamine, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 40 (depends on 36)

The method of claim 36, wherein the chelating agent is present in an amount ranging from about 0.25 mg/mL to about 0.5 mg/mL and is selected from the group consisting of ethylenediaminetetraacetic acid, diethylenetriamine pentaacetic acid, ethylene glycol tetraacetic acid, etidronate, dimercaptosuccinic acid, deferoxamine, dimercaprol, triethylene tetramine dihydrochloride, zinc citrate, combination of bismuth and citrate, penicillamine, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 41 (depends on 36)

The method of claim 36, wherein the microbial growth inhibiting solution further comprises a buffer present in an amount ranging from about 1.5 to about 24 mM, wherein the C10 or C12 carboxylate antimicrobial agent is present in an amount ranging from about 0.071 mg/mL to about 1.15 mg/mL, and the chelating agent is present in an amount ranging from about 0.0625 mg/mL to about 1 mg/mL.

### Claim 42 (depends on 41)

The method of claim 41, wherein the C10 or C12 carboxylate antimicrobial agent comprises sodium caprate or socium laurate, the buffer comprises citrate, and the chelating agent comprises disodium ethylenediaminetetraacetic acid.

### Claim 43

A kit for locking and/or flushing an implanted catheter, the kit comprising:
a container holding a volume of a microbial growth inhibiting solution comprising a C10 or C12 carboxylate antimicrobial agent and a chelating agent, wherein the C10 or C12 carboxylate antimicrobial agent is present in an amount ranging from about 0.05 mg/mL to about 5 mg/mL and the chelating agent is present in an amount ranging from about 0.01 mg/mL to about 2 mg/m, and wherein the solution has a pH of 5.2 or less L; and
an implantable catheter lumen that receives the microbial growth inhibiting solution.

### Claim 44 (depends on 43)

The kit of claim 43, wherein the container comprises a syringe.

### Claim 45 (depends on 43)

The kit of claim 43, wherein the C10 or C12 carboxylate antimicrobial agent is selected from the group consisting of:
agents having the formula R—COOH wherein R=C9 or C11 n-alkyl, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 46 (depends on 43)

The kit of claim 43, wherein the C10 or C12 carboxylate antimicrobial agent is selected from the group consisting of n-capric acid, n-lauric acid, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 47 (depends on 43)

The kit of claim 43, wherein the chelating agent is present in an amount ranging from about 0.1 mg/mL to about 1 mg/mL and is selected from the group consisting of ethylenediaminetetraacetic acid, diethylenetriamine pentaacetic acid, ethylene glycol tetraacetic acid, etidronate, dimercaptosuccinic acid, deferoxamine, dimercaprol, triethylene tetramine dihydrochloride, zinc citrate, combination of bismuth and citrate, penicillamine, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 48 (depends on 43)

The kit of claim 43, wherein the chelating agent is present in an amount ranging from about 0.25 mg/mL to about 0.5 mg/mL and is selected from the group consisting of ethylenediaminetetraacetic acid, diethylenetriamine pentaacetic acid, ethylene glycol tetraacetic acid, etidronate, dimercaptosuccinic acid, deferoxamine, dimercaprol, triethylene tetramine dihydrochloride, zinc citrate, combination of bismuth and citrate, penicillamine, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 49 (depends on 43)

The kit of claim 43, wherein the microbial growth inhibiting solution further comprises a buffer present in an amount ranging from about 1.5 to about 24 mM, wherein the C10 or C12 carboxylate antimicrobial agent is present in an amount ranging from about 0.5 mM to about 8 mM, and the chelating agent is present in an amount ranging from about 0.0625 mg/mL to about 1 mg/mL.

### Claim 50 (depends on 49)

The kit of claim 49, wherein the C10 or C12 carboxylate antimicrobial agent comprises sodium caprate or socium laurate, the buffer comprises citrate, and the chelating agent comprises disodium ethylenediaminetetraacetic acid.

### Claim 51

A kit for locking and/or flushing an implanted catheter, the kit comprising:
a container having a first compartment holding a C10 or C12 carboxylate antimicrobial agent and a chelating agent in powder form and a second compartment holding a pharmacologically acceptable carrier solution, wherein the C10 or C12 carboxylate antimicrobial agent is present in an amount ranging from about 0.05 mg/mL to about 5 mg/mL and the chelating agent is present in an amount ranging from about 0.01 mg/mL to about 2 mg/mL when mixed with the pharmacologically acceptable carrier solution, and wherein the solution has a pH of 5.2 or less.

### Claim 52 (depends on 51)

The kit of claim 51, wherein the container comprises an implantable catheter lumen or a syringe.

### Claim 53 (depends on 51)

The kit of claim 51, wherein the C10 or C12 carboxylate antimicrobial agent is selected from the group consisting of:
agents having the formula R—COOH wherein R=C9 or C11 n-alkyl, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 54 (depends on 51)

The kit of claim 51, wherein the C10 or C12 carboxylate antimicrobial agent is selected from the group consisting of n-capric acid, n-lauric acid, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 55 (depends on 51)

The kit of claim 51, wherein the chelating agent is present in an amount ranging from about 0.1 mg/mL to about 1 mg/mL when mixed with the pharmacologically acceptable carrier solution and is selected from the group consisting of ethylenediaminetetraacetic acid, diethylenetriamine pentaacetic acid, ethylene glycol tetraacetic acid, etidronate, dimercaptosuccinic acid, deferoxamine, dimercaprol, triethylene tetramine dihydrochloride, zinc citrate, combination of bismuth and citrate, penicillamine, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 56 (depends on 51)

The kit of claim 51, wherein the chelating agent is present in an amount ranging from about 0.25 mg/mL to about 0.5 mg/mL when mixed with the pharmacologically acceptable carrier solution and is selected from the group consisting of ethylenediaminetetraacetic acid, diethylenetriamine pentaacetic acid, ethylene glycol tetraacetic acid, etidronate, dimercaptosuccinic acid, deferoxamine, dimercaprol, triethylene tetramine dihydrochloride, zinc citrate, combination of bismuth and citrate, penicillamine, pharmaceutically acceptable salts thereof and combinations thereof.

### Claim 57 (depends on 51)

The kit of claim 51, wherein first compartment or the second compartment further comprises a buffer present in an amount ranging from about 1.5 to about 24 mM, wherein the C10 or C12 carboxylate antimicrobial agent is present in an amount ranging from about 0.071 mg/mL to about 1.15 mg/mL, and the chelating agent is present in an amount ranging from about 0.0625 mg/mL to about 1 mg/mL when mixed with the pharmacologically acceptable carrier solution.

### Claim 58 (depends on 57)

The kit of claim 57, wherein the C10 or C12 carboxylate antimicrobial agent comprises sodium caprate or socium laurate, the buffer comprises citrate, and the chelating agent comprises disodium ethylenediaminetetraacetic acid.