Evaluation of safety and pharmacokinetics of vancomycin after intraosseous regional limb perfusion and comparison of results with those obtained after intravenous regional limb perfusion in horses.

The research article focuses on assessing the clinical effects and pharmacokinetics of vancomycin in horses, when administered through intraosseous regional limb perfusion (IORLP), and contrasts the results with those garnered from intravenous regional limb perfusion (IVRLP).

Objective of the Research

The research was conducted with the objective to compare and understand:

• The clinical impact and behavior (pharmacokinetics) of vancomycin, when introduced through IORLP and IVRLP.
• The concentration levels of vancomycin in plasma and synovial fluid.
• The safety and potential clinical usage of both means of administration in horses suffering from infectious processes affecting different joints.

Research Methodology

For the research, a group of six horses were selected.

• An amount of 300 mg vancomycin hydrochloride, dissolved in 60 mL of saline solution, was administered via IORLP into one forelimb of each horse. The opposite limb was given saline solution as a control reference.
• The solutions were injected directly into the inner part of the distal portion of the third metacarpal bone of the horses.
• At regular time intervals (15, 30, 45, 65, and 90 mins post injection, and again after 4, 8, 12, 24 hours), samples of blood and synovial fluid were collected from different joints.
• The plasma concentrations of urea and creatinine, and the clinical condition of the joints and infusion sites were monitored for a week.

Findings of the Study

The result of the research show that:

• No clinical complications were noticed post administration of IORLP.
• The average concentration of vancomycin persisted at 4 micrograms/mL in the MTCP joint for 24 hours following IORLP.
• Contrasting to IORLP, higher concentrations of vancomycin were detected in the DIP joint following IVRLP.
• On the contrary, a protracted presence of higher vancomycin concentrations was noticed in the MTCP joint after IORLP as opposed to IVRLP.

Conclusions drawn from the Research

Drawing conclusions from these findings, the researchers indicate that:

• Administering 300mg of vancomycin in a 0.5% solution via IORLP is safe and could have potential clinical applications in horses.
• Depending on the kind of infection and the joint that is affected, either intravenous or intraosseous administration routes may be more appropriate.