Different methods of perfusate administration do not have an effect on synovial concentrations of amikacin following intravenous regional limb perfusion.

The research investigates whether different methods of perfusate administration have an effect on synovial concentrations of amikacin following intravenous regional limb perfusion. The results show that no matter how amikacin is administered, the concentrations achieved in the joint fluid are not significantly different.

Objective

This research was conducted with the objective of determining if different methods of administering perfusate – a fluid for intravenous use – would have any effect on the concentrations of the antibiotic amikacin in the joint fluid, specifically in the radiocarpal joint (RCJ), following intravenous regional limb perfusion (IVRLP) in horses.

Method

• Six healthy horses participated in the study.
• Two methods of perfusate administration were used. In the first method (perfusate-A), 2 g of amikacin was followed by 52 ml of 0.9% NaCl (combined total volume of 60 ml). In the second method (perfusate-D), 2 g of amikacin was diluted using 0.9% NaCl to bring the total volume of the solution to 60 ml.
• The perfusate was administered over a period of five minutes in both cases.
• Joint fluid from the radiocarpal joint was sampled at five different times – 10, 15, 20, 25, and 30 minutes after the perfusate was instilled.
• Systemic concentrations of amikacin (i.e., concentrations in the overall body system) were measured at various points before, during, and after perfusion.
• The amikacin concentrations were determined using an analytical method known as fluorescence polarization immunoassay, which is capable of quantifying small amounts of a substance in a solution.

Results

• The peak synovial concentration in the radiocarpal joint was found to be similar in both methods of perfusate administration.
• Similarly, there was no significant difference in the length of time before the peak concentration was reached.
• Differences in systemic amikacin concentrations over time between the two groups were also found to be insignificant.
• All horses included in this study reached the target synovial amikacin concentration of over 160 μg/mL, indicating that both methods were effective.

Conclusion

The study concluded that different methods of perfusate administration did not have any significant effect on the synovial concentrations of amikacin when performing intravenous regional limb perfusion (IVRLP). Therefore, there is no advantage in administering amikacin first, suggesting that the order of administration does not influence the effectiveness of the medication.