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Polymers 2011, 3, 340-366; doi:10.3390/polym3010340 OPEN ACCESS polymers ISSN 2073-4360 /journal/polymers Review New Strategies in the Development of Antimicrobial Coatings: The Example of Increasing Usage of Silver and Silver Nanoparticles Menno L. W. Knetsch * and Leo H. Koole Department of Biomedical Engineering/Biomaterials Science, Faculty Health, Medicine, and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands; E-Mail: l.koole@maastrichtuniversity.nl * Author to whom correspondence should be addressed; E-Mail: menno.knetsch@maastrichtuniversity.nl; Tel.: +31-43-3881272; Fax: +31-43-3881725. Received: 15 November 2010; in revised form: 23 December 2010 / Accepted: 24 January 2011 / Published: 26 January 2011 Abstract: Bacterial infection from medical devices is a major problem and accounts for an increasing number of deaths as well as high medical costs. Many different strategies have been developed to decrease the incidence of medical device related infection. One way to prevent infection is by modifying the surface of the devices in such a way that no bacterial adhesion can occur. This requires modification of the complete surface with, mostly, hydrophilic polymeric surface coatings. These materials are designed to be non-fouling, meaning that protein adsorption and subsequent microbial adhesion are minimized. Incorporation of antimicrobial agents in the bulk material or as a surface coating has been considered a viable alternat