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Veterinary surgery : VS2022; 51(4); 665-673; doi: 10.1111/vsu.13789

Effect of perfusate volume on amikacin concentrations after saphenous intravenous regional limb perfusion in standing, sedated horses.

Abstract: To determine the influence of perfusate volume on synovial fluid amikacin concentrations in the joints of the hind limb after standing saphenous intravenous regional limb perfusion (IVRLP). Methods: Randomized crossover design. Methods: Six adult horses. Methods: Saphenous IVRLP was performed in 6 standing horses with 1 g of amikacin diluted with 0.9% NaCl to volumes of 10 ml, 60 ml, and 120 ml. Samples of synovial fluid from the tarsocrural, metatarsophalangeal, and hind limb distal interphalangeal joints were collected at 15 and 30 min after perfusate administration. Concentrations of 40 μg/ml and 160 μg/ml were considered therapeutic for susceptible and resistant pathogens, respectively. Results: No difference in synovial fluid amikacin concentrations was detected between volumes in any joint (P = .4). All synovial fluid amikacin concentrations were higher at 30 min compared to 15 min (P = .003). All median synovial fluid amikacin concentrations at 30 min were > 40 μg/ml using the 60 ml and 120 ml volumes. Synovial fluid amikacin concentrations >40 μg/ml were only reached in the hind limb distal interphalangeal joint when the 10 ml volume was used. All median synovial fluid amikacin concentrations observed were < 160 μg/ml. Conclusions: Target concentrations for pathogens that were considered susceptible were consistently reached with perfusate volumes of 60 ml and 120 ml. However, median synovial fluid amikacin concentrations did not reach target levels for resistant pathogens. Conclusions: Perfusate volumes of 60 ml or 120 ml are recommended to treat infections due to susceptible pathogens in the joints of the distal hind limb. These results justify investigation of saphenous IVRLP with different perfusate volumes using higher doses of amikacin.
© 2022 American College of Veterinary Surgeons.
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Publication Date: 2022-03-02 PubMed ID: 35234300DOI: 10.1111/vsu.13789Google Scholar: Lookup
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  • Journal Article

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 examined the impact of perfusate volume, or the liquid infused into a horse’s limb, on the concentrations of the antibiotic amikacin in the synovial fluid of the horse’s hind limb joints. The study found that perfusate volumes of 60 ml or 120 ml achieved desirable antibiotic concentrations for certain pathogens, but not for resistant ones, which calls for further research using higher doses of amikacin.

Methods

  • The study followed a randomized crossover design using six adult horses.
  • The method under investigation, known as saphenous intravenous regional limb perfusion (IVRLP), involved introducing amikacin, an antibiotic, into the horse’s limb for treating joint infections.
  • Three different volumes of perfusate were used — 10 ml, 60 ml, and 120 ml — each diluted with 0.9% sodium chloride (NaCl) and mixed with one gram of amikacin.
  • Samples of synovial fluid from three different joints in the horse’s hind limb were collected at two different time intervals — 15 minutes and 30 minutes after introducing the perfusate.
  • The study defined two therapeutic concentrations of amikacin: 40 μg/ml for susceptible pathogens and 160 μg/ml for resistant pathogens.

Results

  • There was no measurable difference in antibiotic concentration between the varying volumes of perfusate in any of the joints studied.
  • The concentration of amikacin in the synovial fluid increased from the 15-minute mark to the 30-minute mark in all examples.
  • Sufficient therapeutic levels (> 40 μg/ml) for treating susceptible pathogens were achieved in all instances using the 60 ml and 120 ml volumes. For the 10 ml volume, this level was only achieved in one specific joint, the hind limb distal interphalangeal joint.
  • The therapeutic concentration (160 μg/ml) for the resistant pathogens was not achieved in any cases.

Conclusions

  • The study concluded that a perfusate volume of 60 ml or 120 ml is recommended to treat infections due to susceptible pathogens in the joints of a horse’s hind limb.
  • For resistant pathogens, these volumes did not result in effective treatment. Given these findings, additional investigation is recommended, possibly adjusting the dosage of amikacin or the perfusate volume.

Cite This Article

APA
Jurek KA, Schoonover MJ, Williams MR, Rudra P. (2022). Effect of perfusate volume on amikacin concentrations after saphenous intravenous regional limb perfusion in standing, sedated horses. Vet Surg, 51(4), 665-673. https://doi.org/10.1111/vsu.13789

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 51
Issue: 4
Pages: 665-673

Researcher Affiliations

Jurek, Kelsey A
  • Department of Veterinary Clinical Sciences, Oklahoma State University, College of Veterinary Medicine, Stillwater, Oklahoma, USA.
Schoonover, Mike J
  • Department of Veterinary Clinical Sciences, Oklahoma State University, College of Veterinary Medicine, Stillwater, Oklahoma, USA.
Williams, Megan R
  • Department of Veterinary Clinical Sciences, Oklahoma State University, College of Veterinary Medicine, Stillwater, Oklahoma, USA.
Rudra, Pratyaydipta
  • Department of Statistics, Oklahoma State University, College of Arts and Sciences, Stillwater, Oklahoma, USA.

MeSH Terms

  • Administration, Intravenous / veterinary
  • Amikacin / pharmacology
  • Animals
  • Anti-Bacterial Agents / pharmacology
  • Forelimb
  • Horses
  • Perfusion / veterinary
  • Synovial Fluid

Grant Funding

  • Aurora Pharmaceutical, Inc.
  • Research Advisory Committee, Oklahoma State University, College of Veterinary Medicine

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Citations

This article has been cited 1 times.
  1. Valverde A, Cribb N, Arroyo L. Morphine concentrations in distal thoracic limb synovial fluid following intravenous regional limb perfusion in horses. Can J Vet Res 2023 Oct;87(4):254-259.
    pubmed: 37790266
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