Comparison of intraosseous or intravenous infusion for delivery of amikacin sulfate to the tibiotarsal joint of horses.
Abstract: To establish the route of infusion (IV or intraosseous) that results in the highest concentration of amikacin in the synovial fluid of the tibiotarsal joint and determine the duration of peak concentrations. Methods: 21 horses. Methods: Regional perfusion of a limb on 15 horses was performed. Amikacin sulfate was infused into the saphenous vein or via intraosseous infusion into the distal portion of the tibia (1 g in 56 ml of lactated Ringer's solution) or proximal portion of the metatarsus (1 g of amikacin in 26 ml of lactated Ringer's solution). Amikacin concentrations were measured in sequential samples from tibiotarsal joint synovial fluid and serum. Samples were obtained immediately prior to release of the tourniquet and 0.5, 1, 4, 8, 12, and 24 hours after the tourniquet was released. Radiographic contrast material was infused into the same locations as the antibiotic perfusate to evaluate distribution in 6 other horses. Results: Infusion into the saphenous vein produced the highest concentration of amikacin in the tibiotarsal joint, compared with the distal portion of the tibia (mean +/- SE, 701.8 +/- 366.8 vs 203.8 +/- 64.5 microg/ml, respectively). Use of a lower volume of diluent in the proximal portion of the metatarsus produced a peak value of 72.2 +/- 23.4 microg/ml. Conclusions: For regional perfusion of the tarsus, IV infusion is preferred to intraosseous infusion, because higher concentrations are achieved in the synovial fluid, and the procedure is easier to perform.
Publication Date: 2002-03-26 PubMed ID: 11911572DOI: 10.2460/ajvr.2002.63.374Google Scholar: Lookup
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- Comparative Study
- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The research article seeks to determine the optimal method of amikacin sulfate delivery in horses, between intraosseous infusion and intravenous (IV) infusion, for maximum concentration in the synovial fluid of the tibiotarsal joint and to understand the duration of such concentration.
Experiment Design
- 21 horses were selected for the research, and regional perfusion was performed on 15 of them.
- The researchers decided on two methods of amikacin sulfate infusion: via the saphenous vein and via intraosseous infusion into the distal portion of the tibia or the proximal portion of the metatarsus.
- The drug was infused in different volumes among the chosen routes: 1 g of amikacin sulfate in 56 ml of lactated Ringer’s solution for the saphenous vein and the distal tibia, while 1 g of amikacin in 26 ml of lactated Ringer’s solution for the proximal metatarsus.
- Sequential samples from the tibiotarsal joint synovial fluid and serum were then collected at different time intervals (immediately before releasing the tourniquet and after 0.5, 1, 4, 8, 12, and 24 hours).
Results
- The saphenous vein infusion yielded the highest concentration of amikacin in the tibiotarsal joint. The mean concentration was 701.8 microg/ml, which was significantly higher than the 203.8 microg/ml concentration resulting from the tibia infusion and 72.2 microg/ml from the metatarsus infusion.
- However, the concentration of amikacin in the synovial fluid using lower diluent volume in the metatarsus produced the least mean value of 72.2 +/- 23.4 microg/ml.
Conclusion
- The study concluded that, for regional perfusion of the tarsus in horses, IV infusion is preferable to intraosseous infusion. This conclusion was reached because a higher concentration of amikacin was achieved in the synovial fluid with IV infusion, and the procedure was also more straightforward.
Cite This Article
APA
Scheuch BC, Van Hoogmoed LM, Wilson WD, Snyder JR, MacDonald MH, Watson ZE, Steffey EP.
(2002).
Comparison of intraosseous or intravenous infusion for delivery of amikacin sulfate to the tibiotarsal joint of horses.
Am J Vet Res, 63(3), 374-380.
https://doi.org/10.2460/ajvr.2002.63.374 Publication
Researcher Affiliations
- Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis 95616, USA.
MeSH Terms
- Amikacin / administration & dosage
- Amikacin / pharmacokinetics
- Animals
- Anti-Bacterial Agents / administration & dosage
- Anti-Bacterial Agents / pharmacokinetics
- Area Under Curve
- Female
- Half-Life
- Horse Diseases / diagnostic imaging
- Horse Diseases / drug therapy
- Horse Diseases / metabolism
- Horses / metabolism
- Infusions, Intraosseous / veterinary
- Injections, Intravenous / veterinary
- Joint Diseases / diagnostic imaging
- Joint Diseases / drug therapy
- Joint Diseases / metabolism
- Joint Diseases / veterinary
- Male
- Radiography
- Synovial Fluid / metabolism
- Tarsal Joints / metabolism
Citations
This article has been cited 12 times.- Mizuguchi Y, Kato A, Aizu M. Regional antibiotic perfusion through the lateral saphenous vein in two horses with septic calcaneal osteitis.. J Vet Med Sci 2023 Jan 6;85(1):55-61.
- 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.
- 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).
- 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.
- Gustafsson K, Tatz AJ, Dahan R, Abu Ahmad W, Britzi M, Sutton GA, Kelmer G. Synovial Concentration of Trimethoprim-Sulphadiazine Following Regional Limb Perfusion in Standing Horses.. Animals (Basel) 2021 Jul 13;11(7).
- Young SW, Zhang M, Moore GA, Pitto RP, Clarke HD, Spangehl MJ. The John N. Insall Award: Higher Tissue Concentrations of Vancomycin Achieved With Intraosseous Regional Prophylaxis in Revision TKA: A Randomized Controlled Trial.. Clin Orthop Relat Res 2018 Jan;476(1):66-74.
- Nieto JE, Trela J, Stanley SD, Yamout S, Snyder JR. Pharmacokinetics of a combination of amikacin sulfate and penicillin G sodium for intravenous regional limb perfusion in adult horses.. Can J Vet Res 2016 Jul;80(3):230-5.
- 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.
- 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.
- 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.
- Young SW, Zhang M, Freeman JT, Vince KG, Coleman B. Higher cefazolin concentrations with intraosseous regional prophylaxis in TKA.. Clin Orthop Relat Res 2013 Jan;471(1):244-9.
- 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.
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