Evaluation of regional limb perfusion with chloramphenicol using the saphenous or cephalic vein in standing horses.
Abstract: Regional limb perfusion (RLP) significantly decreases morbidity and mortality associated with distal limb injuries in horses. There is an urgent need for finding additional effective antimicrobial drugs for use in RLP. In this study, we tested the pharmacokinetics (PK) of chloramphenicol in RLP. Eight horses participated in the study, which was approved by the University Animal Care and Use Committee. The cephalic and the saphenous veins were used to perfuse the limbs. Synovial samples were collected from the metacarpo/metatarsophalangeal (MCP/MTP) joint. The Friedman Test was applied for assessing change in PK concentration over time, for all time points. The Wilcoxon Signed Ranks Test was used to test the difference between PK concentration in joint & serum as well as concentration in joint vs. MIC. The comparison of measurements between measurements taken on hind vs. front legs was carried out using the Mann-Whitney Test. A P-value of 5% or less was considered statistically significant. After RLP, the concentration of chloramphenicol in the synovial fluid of the MCP/MTP joint using either the cephalic or the saphenous vein was initially far above the minimal inhibitory concentration (MIC) of most susceptible pathogens and remained above the MIC for approximately 6 h. The results indicate that performing RLP using the cephalic and saphenous veins enables reaching concentrations of chloramphenicol in the MCP/MTP joint that are well above the MIC of most susceptible pathogens. The chloramphenicol concentrations achieved in the synovial fluid of the MCP/MTP joint in the current study were between 1.5 (MTP) and 7 (MCP) times the MIC of MRSA in horses. These results are encouraging since MRSA infections are becoming far more common, causing considerable morbidity. To the best of our knowledge, this is the first study to evaluate the pharmacokinetics of chloramphenicol following RLP in the horse and the results are positive.
© 2014 John Wiley & Sons Ltd.
Publication Date: 2014-07-30 PubMed ID: 25073920DOI: 10.1111/jvp.12140Google Scholar: Lookup
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- Clinical Trial
- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The research article is about a study on the use of chloramphenicol in regional limb perfusion (RLP) in horses. The study reveals that performing RLP using either the cephalic or saphenous veins results in chloramphenicol concentrations in the joint that are above the minimum inhibitory concentrations (MIC) for about six hours, making it a potential treatment for infections in limb injuries in horses.
Research Context and Methodology
- The focus of the study was to assess the effectiveness of chloramphenicol, an antimicrobial drug, when used in regional limb perfusion (RLP), a treatment method for distal limb injuries in horses.
- Eight horses were involved in the experiment, with the saphenous and cephalic veins used to perfuse the limbs during the RLP process.
- The researchers collected synovial samples from each horse’s metacarpo/metatarsophalangeal (MCP/MTP) joint after RLP to examine the concentration of chloramphenicol in the joint’s synovial fluid.
Results and Findings
- The concentration of chloramphenicol was initially found to be well above the minimum inhibitory concentration (MIC)—the lowest concentration of an antimicrobial drug that prevents the growth of a microorganism—of most susceptible pathogens after RLP.
- This concentration of the drug in the synovial fluid of the MCP/MTP joint remained above the MIC for approximately six hours after the procedure.
- The researchers also discovered that the concentrations of chloramphenicol achieved in the synovial fluid was between 1.5 and 7 times the MIC of MRSA—a type of bacterium that is resistant to many antibiotics—in horses.
Statistical Analysis and Techniques
- The Friedman Test was used to evaluate the change in PK (pharmacokinetics) concentration over time.
- The Wilcoxon Signed Ranks Test evaluated the differences between PK concentrations in joint & serum and between joint concentration versus MIC.
- The Mann-Whitney Test facilitated the comparison of measurements done on hind legs versus front legs of the horses.
Conclusion: Implications and Potential Applications
- This study is the first to explore the pharmacokinetics of chloramphenicol after using RLP in horses.
- The results suggest chloramphenicol could be a potential effective treatment in RLP for horses suffering from distal limb injuries.
- Given the rising concern about MRSA infections in horses, the effective concentration of chloramphenicol against these pathogens presents a significant therapeutic prospect.
Cite This Article
APA
Kelmer G, Tatz AJ, Famini S, Bdolah-Abram T, Soback S, Britzi M.
(2014).
Evaluation of regional limb perfusion with chloramphenicol using the saphenous or cephalic vein in standing horses.
J Vet Pharmacol Ther, 38(1), 35-40.
https://doi.org/10.1111/jvp.12140 Publication
Researcher Affiliations
- Department of Large Animal Medicine and Surgery, Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel.
MeSH Terms
- Animals
- Anti-Bacterial Agents / administration & dosage
- Area Under Curve
- Chloramphenicol / administration & dosage
- Drug Administration Routes
- Female
- Forelimb / blood supply
- Half-Life
- Horses
- Male
Citations
This article has been cited 5 times.- 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.
- 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.
- Bonilla AG, Causeret L, Torrent-Crosa A. Pharmacokinetics of ceftiofur in the metacarpophalangeal joint after standing intravenous regional limb perfusion in horses. Can Vet J 2021 Sep;62(9):975-981.
- 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).
- Mosichuk AP, Smith JS, Tatarniuk DM, Troy JR, Kreuder AJ. Meropenem Administered via Intravenous Regional Limb Perfusion for Orthopedic Sepsis in Horses: A Clinical Retrospective Study. Front Vet Sci 2021;8:629627.
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