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The Canadian veterinary journal = La revue veterinaire canadienne2001; 42(8); 617-622;

Comparison of 2 techniques for regional antibiotic delivery to the equine forelimb: intraosseous perfusion vs. intravenous perfusion.

Abstract: The purpose of this study was to compare the synovial fluid concentrations and pharmacokinetics of amikacin in the equine limb distal to the carpus following intraosseous and intravenous regional perfusion. The front limbs of 6 horses were randomly assigned to either intraosseous or intravenous perfusion. A tourniquet was placed distal to each carpus and the limb perfused with 500 mg of amikacin. Systemic blood samples and synovial fluid samples were collected over 70 min from the distal interphalangeal (DIP) joint, metacarpophalangeal joint, and digital flexor sheath. The tourniquet was removed following the 30 min sample collection. The mean peak amikacin concentration for the DIP joint was significantly higher with intravenous perfusion. There were no significant differences in time to peak concentration or elimination half-life between methods at each synovial structure. Each technique produced mean peak concentrations ranging from 5 to 50 times that of recommended peak serum concentrations for therapeutic efficacy.
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Publication Date: 2001-08-25 PubMed ID: 11519271PubMed Central: PMC1476572
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  • Clinical Trial
  • Comparative Study
  • Journal Article
  • Randomized Controlled Trial
  • Research Support
  • Non-U.S. Gov't

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research study investigates two techniques for delivering antibiotics to a horse’s lower front leg: through the bone (intraosseous) and through the vein (intravenous). The study particularly talks about the distribution and action over time of the antibiotic amikacin. The results show that the technique used did not significantly affect the time for the drug to reach its peak concentration or the time it took for half of the drug to be eliminated. However, the antibiotic concentration was significantly higher in the lowermost joint when delivered through the veins.

Assessment of Antibiotic Delivery Methods

  • The study sets out to compare the concentration and pharmacokinetics of an antibiotic called amikacin in the lower leg (distal to the carpus) of horses.
  • The research uses six horses’ front limbs, randomly assigning them to either intraosseous (into the bone) or intravenous (into the vein) perfusion for antibiotic delivery.
  • By using a tourniquet (a compression device) placed below the carpus, the researchers control the dispersal of antibiotic which is introduced in a dose of 500 mg.

Data Collection and Results

  • Systemic blood samples and synovial fluid samples (fluid in the joint spaces) were gathered over a 70-minute interval from the lowermost joint (distal interphalangeal or DIP joint), the metacarpophalangeal joint, and the digital flexor sheath, a fibrous tissue helping in the flexing of the digits.
  • The tourniquet was detached after the sample collection at 30 minutes.
  • The study concluded that the intravenous method resulted in a notably higher mean peak concentration of amikacin in the DIP joint.

Analyzing Time to Peak and Elimination Half-Life

  • Moreover, both methods did not show significant differences in ‘time to peak concentration’ – the time taken for the drug to reach its highest level in the concerned tissues.
  • Neither was there any substantial difference in ‘elimination half-life’, the time required for the concentration of the drug to decrease by half.
  • Both techniques yielded mean peak concentrations that were 5 to 50 times the suggested highest serum concentrations considered effective for therapy, suggesting both methods could potentially deliver therapeutic levels of the drug.

Cite This Article

APA
Butt TD, Bailey JV, Dowling PM, Fretz PB. (2001). Comparison of 2 techniques for regional antibiotic delivery to the equine forelimb: intraosseous perfusion vs. intravenous perfusion. Can Vet J, 42(8), 617-622.

Publication

The Canadian veterinary journal = La revue veterinaire canadienne
ISSN: 0008-5286
NlmUniqueID: 0004653
Country: Canada
Language: English
Volume: 42
Issue: 8
Pages: 617-622

Researcher Affiliations

Butt, T D
  • Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, Saskatchewan S7N 5B4.
Bailey, J V
    Dowling, P M
      Fretz, P B

        MeSH Terms

        • Amikacin / administration & dosage
        • Amikacin / pharmacokinetics
        • Animals
        • Anti-Bacterial Agents / administration & dosage
        • Anti-Bacterial Agents / pharmacokinetics
        • Chemotherapy, Cancer, Regional Perfusion / methods
        • Chemotherapy, Cancer, Regional Perfusion / veterinary
        • Cross-Over Studies
        • Female
        • Forelimb
        • Horses / metabolism
        • Infusions, Intraosseous / methods
        • Infusions, Intraosseous / veterinary
        • Infusions, Intravenous / methods
        • Infusions, Intravenous / veterinary
        • Male
        • Synovial Fluid / metabolism

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        Citations

        This article has been cited 10 times.
        1. Wells Z, Zhu M, Young SW. Intraosseous Regional Administration of Prophylactic Antibiotics in Total Knee Arthroplasty. Antibiotics (Basel) 2022 May 9;11(5).
          doi: 10.3390/antibiotics11050634pubmed: 35625278google scholar: lookup
        2. Redding LE, Elzer EJ, Ortved KF. Effects of regional limb perfusion technique on concentrations of antibiotic achieved at the target site: A meta-analysis. PLoS One 2022;17(4):e0265971.
          doi: 10.1371/journal.pone.0265971pubmed: 35363825google scholar: lookup
        3. Vajs T, Nekouei O, Biermann NM. A Descriptive Study of the Clinical Presentation, Management, and Outcome of Horses with Acute Soft Tissue Trauma of the Tarsus and the Association with Synovial Involvement. Animals (Basel) 2022 Feb 21;12(4).
          doi: 10.3390/ani12040524pubmed: 35203232google scholar: lookup
        4. de Souza Garcia AF, Ribeiro G, de Assis Arantes J, Reginato GM, Xavier NV, Carregaro AB, Silva TJF, Grigoletto R, de Freitas SH, Dória RGS. Evaluation of totally implantable catheters in healthy horses. BMC Vet Res 2021 Oct 26;17(1):339.
          doi: 10.1186/s12917-021-03052-zpubmed: 34702265google scholar: lookup
        5. Dória RG, Carvalho MB, Freitas SH, Laskoski LM, Colodel EM, Mendonça FS, Silva MA, Grigoletto R, Fantinato Neto P. Evaluation of intravenous regional perfusion with amphotericin B and dimethylsulfoxide to treat horses for pythiosis of a limb. BMC Vet Res 2015 Jul 16;11:152.
          doi: 10.1186/s12917-015-0472-zpubmed: 26174778google scholar: lookup
        6. Hunter BG, Duesterdieck-Zellmer KF, Larson MK. Tiludronate concentrations and cytologic findings in synovial fluid after intravenous regional limb perfusion with tiludronate in horses. PeerJ 2015;3:e889.
          doi: 10.7717/peerj.889pubmed: 25945303google scholar: lookup
        7. Hyde RM, Lynch TM, Clark CK, Slone DE, Hughes FE. The influence of perfusate volume on antimicrobial concentration in synovial fluid following intravenous regional limb perfusion in the standing horse. Can Vet J 2013 Apr;54(4):363-7.
          pubmed: 24082163
        8. Young SW, Zhang M, Freeman JT, Mutu-Grigg J, Pavlou P, Moore GA. The Mark Coventry Award: Higher tissue concentrations of vancomycin with low-dose intraosseous regional versus systemic prophylaxis in TKA: a randomized trial. Clin Orthop Relat Res 2014 Jan;472(1):57-65.
          doi: 10.1007/s11999-013-3038-zpubmed: 23666589google scholar: lookup
        9. Clark C, Greenwood S, Boison JO, Chirino-Trejo M, Dowling PM. Bacterial isolates from equine infections in western Canada (1998-2003). Can Vet J 2008 Feb;49(2):153-60.
          pubmed: 18309745
        10. Viswanathan VK, Patralekh MK, Iyengar KP, Jain VK. Intraosseous regional antibiotic prophylaxis in total joint arthroplasty (TJA): Systematic review and meta-analysis. J Clin Orthop Trauma 2024 Oct;57:102553.
          doi: 10.1016/j.jcot.2024.102553pubmed: 39435324google scholar: lookup
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