Taurolidine: From early discovery to current practice

Anti-tumour efficacy

In several earlier publications, taurolidine has been described as a “chemotherapeutic agent” [1,5] due to its impact on cancer cells. A 2000 study found that taurolidine exposure could inhibit the growth of tumour cells significantly, both in vitro and in vivo (when tested on animals). Further studies confirmed that it had the same effect on human tumour cells. [5,6]. The antineoplastic (i.e. anti-cancer) activity of taurolidine proved strong enough to “enhance apoptosis, inhibit angiogenesis, reduce tumour adherence, downregulate proinflammatory cytokine release, and stimulate anticancer immune regulation following surgical trauma”. [3] 

Immunoregulation

The discovery of taurolidine’s anti-tumour efficacy went hand in hand with research on how it affects the immune system. While counteracting the proliferation of cancer cells, it also blocked the synthesis of IL-10 and TNF proteins. [7] These proteins act as inflammatory markers: When found at increased levels in the body, they indicate that the immune system is currently fighting off an infection. Lower levels of these proteins in turn indicate an improved inflammatory profile. [8] Scientists therefore came to the conclusion that taurolidine might be “an effective immunomodulatory agent in a clinical setting”. [9]

Antibiofilm efficacy

Findings on the anti-tumour and immunoregulative properties of taurolidine set the stage for another field of research: Its effect on so-called biofilm. Generally speaking, biofilm is a thin layer of microorganisms that grows on many wet surfaces. It provides a perfect breeding ground for germs and therefore poses a severe threat in clinical contexts. Oftentimes, the formation of biofilm is the first step in developing an infection. It not only invites microorganisms to accumulate and proliferate, but also makes them more resistant. Once they have settled, many microorganisms enter a state known as “dormancy”. They stop growing and become less sensitive to attacks from the immune system or antibiotic exposure. [10] Therefore, dormant or “mature” pathogens are particularly dangerous for patients at risk of infection. Taurolidine has proven itself as a useful agent to fight this threat. In the past 25 years, numerous studies have demonstrated how it not only prevents, but even eradicates biofilm that has already developed. [11,12,13,14]. Taurolidine exhibits a strong antimicrobial activity against a broad range of bacteria and fungi, especially those known to commonly cause infections. This includes vancomycin-resistant enterococci (VRE), methicillin-resistant S. aureus (MRSA), and Candida albicans, among others. [14] Scientists also found that taurolidine can inactivate more mature biofilm at stages where other antimicrobial agents become ineffective. [15] 

Taurolidine to treat infection

Clinical evidence for taurolidine in the treatment of peritonitis (i.e. inflammation and infection within the abdominal cavity) was first published in the mid-1980s. Two randomised studies found its antimicrobial activity facilitated the healing process and reduced the risk of complications. [16,17,18] This was further substantiated by several publications during the 1990s. [18,19,20]  
Most recently, a case report from Iran deemed taurolidine a “promising therapeutic option for challenging wound infections”. [21] The study group came to this conclusion after successfully treating a 17-year-old patient with a stage III ulcer. Antibiotics, regular debridement, and dressing changes were all in vain. But finally, irrigating the ulcer with a taurolidine solution resulted in progressive wound granulation and complete reepithelialisation after 2 months. The patient remained fully healed without any adverse effects after one year.  
All in all, taurolidine has shown great potential as a therapeutic agent. Still, this potential has yet to be implemented and standardised in medical practice. Research on the treatment of peritonitis did, however, pave the way for another field of application: Lock solutions for central-venous catheters.  

Central-venous catheters are lifelines in the most literal sense: Patients depend on them to survive. But they also carry the risk of complications that might lead to possibly life-threatening infections. Such complications often start with the formation of biofilm within the catheter: As bacteria and fungi accumulate and proliferate, they also grow more resistant over time. Once these pathogens enter the patient’s bloodstream, they can cause a catheter-related bloodstream infection (CRBSI) that might end deadly. Consequently, it is crucial to prevent biofilm formation in the first place. As illustrated above, clinical evidence has shown that taurolidine does exactly that. The founders of TauroPharmthus came up with the idea of taurolidine-based lock solutions for central-venous catheters.  

Today, we have a range of products that all contain taurolidine as an antimicrobial agent. Four of these products also contain other active ingredients, to meet the individual needs of different patients: Tailor-made catheter lock solutions.

Over the past 20 years, numerous studies have confirmed the efficacy of taurolidine-based lock solutions (and TauroLock™ products, specifically) in all relevant fields of application. The increasing amount of clinical evidence has in turn prompted national and international guidelines to include taurolidine in their recommendations. All of these publications (both studies and guidelines) can be accessed and downloaded on our website.  

To solve this problem, TauroPharm has developed TauroPace™. Like TauroLock™ products, this solution also contains taurolidine as a further component with antimicrobial efficacy. When used in CIED procedures (placement, removal, or revision), it proved to protect patients against infections. As of 2025, two studies have confirmed the efficacy of TauroPace™.

• The first clinical trial was published in 2023. It reported that the use of TauroPace™; during 654 procedures on 631 patients resulted in 0.00 CIED infections (within the 3-month follow-up). [24]
• In 2024, an early report from the European registry shared the results of a clinical trial including 822 CIED procedures with the use of TauroPace™. The CIED infection rate amounted to 0.125 % three months post procedure. [25] 

More studies are expected to be published in the foreseeable future, but the evidence available to date leaves little doubt about the potential of taurolidine in cardiac surgery. As Prof. Charles J. Love put it in an editorial commentary from 2023: “Taurolidine may be one step closer to the ‘Silver Bullet’ that will kill the microbes, prevent CIED infection, and not affect the host.” [2]