Anti-microbial coatings and powders and method of forming same on medical devices are provided. The coatings are formed by depositing an anti-microbial biocompatible metal by vapour deposition techniques to produce atomic disorder in the coating such that a sustained release of metal ions sufficient to produce an anti-microbial effect is achieved. Preferred deposition conditions to achieve atomic disorder include a lower than normal substrate temperature, and one or more of a higher than normal working gas pressure and a lower than normal angle of incidence of coating flux. Anti-microbial powders formed by mechanical working to produce atomic disorder are also provided. The anti-microbial effect of the coatings or powders may be further activated or enhanced by irradiating with a low linear energy transfer form of radiation such as gamma radiation.