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Frontiers in veterinary science2021; 8; 629627; doi: 10.3389/fvets.2021.629627

Meropenem Administered via Intravenous Regional Limb Perfusion for Orthopedic Sepsis in Horses: A Clinical Retrospective Study.

Abstract: Septic synovitis is a critical orthopedic condition in horses. Early intervention is key, with antibiotic therapy typically initiated prior to culture and susceptibility reports becoming available. The pharmacokinetics of several antibiotics have been studied in horses for use in intravenous regional limb perfusion (IVRLP) for septic synovitis, including the carbapenem antibiotic, meropenem. For a variety of factors, some veterinary clinicians may select IVRLP meropenem as therapy for these cases. Meropenem is a vital antibiotic in human medicine, making veterinary use divisive. However, verifying the efficacy of meropenem contrasted to other IVRLP antibiotics is essential for appropriate antimicrobial stewardship. To investigate this, equine patient medical records at a single veterinary teaching hospital were examined. Cases treated with meropenem or gentamicin via IVRLP for septic synovitis were retrospectively analyzed for demographics, diagnostics, treatments, outcomes, and adverse effects. Twenty-three meropenem and 37 gentamicin treated horses were analyzed; demographic information was similar between groups. In the meropenem group, nine horses received meropenem only; the remainder received another antibiotic initially then changed to meropenem. Structures infected included joints (meropenem = 13, gentamicin = 17), tendon sheaths (meropenem = 5, gentamicin = 8) and navicular bursae (meropenem = 2, gentamicin = 6). Overall survival to discharge was 86% (52/60), with meropenem 91% (21/23) and gentamicin 84% (31/37), with no statistically significant differences noted between meropenem or gentamicin groups for overall survival to discharge or outcome after discharge. Twenty-four of 26 bacterial isolates obtained from culture were reported as sensitive to imipenem, a carbapenem antibiotic similar to meropenem. Reported susceptibility to other antibiotics such as ceftiofur ( = 22/26), ampicillin ( = 18/26), amikacin ( = 15/26), or gentamicin ( = 12/26) was also frequently present. In the population of this study, antimicrobial activity augmented with IVRLP using either meropenem or gentamicin both appear to be an effective treatment for septic synovial structures, therefore, less critical antimicrobials may be a viable and more judicious treatment option.
Copyright © 2021 Mosichuk, Smith, Tatarniuk, Troy and Kreuder.
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Publication Date: 2021-03-26 PubMed ID: 33842571PubMed Central: PMC8033006DOI: 10.3389/fvets.2021.629627Google Scholar: Lookup
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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 is a retrospective analysis of cases where horses with septic synovitis, a serious orthopedic condition, were treated using either meropenem or gentamicin antibiotics through intravenous regional limb perfusion (IVRLP). The study found that both antibiotics were effective treatments and did not significantly differ in survival outcomes.

Understanding the Research

  • The research focused on a condition called ‘septic synovitis’ which is a serious orthopedic condition often seen in horses. It is usually approached with early, preemptive antibiotic therapy before actual culture and susceptibility reports are obtained.
  • This study particularly examined the use of intravenous regional limb perfusion (IVRLP) method for administering antibiotics in horses. The antibiotics scrutinized in this study were meropenem and gentamicin.
  • Meropenem is a crucial antibiotic in human medicine; hence, its veterinary use is a subject of contention. Since meropenem is a carbapenem antibiotic, the study also considered the sensitivity of various bacterial strains to imipenem, another carbapenem antibiotic.

Execution of the Research

  • For conducting the research, patient records from a single veterinary teaching hospital were studied retrospectively. This involved chiefly examining cases where the horses were treated with either meropenem or gentamicin via IVRLP for septic synovitis.
  • The data was analyzed for different demographics, diagnostics, treatment methods used, outcomes achieved, and any adverse effects observed.
  • The research covered those cases where the horses had infections in joints, tendon sheaths and navicular bursae and had been treated with meropenem or gentamicin.

Findings of the Research

  • There were 23 cases where horses were treated with meropenem and 37 cases where gentamicin was administered; with nine horses in the meropenem group receiving only this antibiotic while the rest were first treated with a different antibiotic before switching to meropenem.
  • The research did not observe any statistically significant differences between the two groups in terms of overall survival to discharge or outcome post-discharge.
  • Out of 26 bacterial isolates obtained from culture, 24 were reported to be sensitive to imipenem, indicating the potential effectiveness of meropenem. Further, sensitivity was also observed to other antibiotics like ceftiofur, ampicillin, amikacin, or gentamicin.
  • The study concluded that IVRLP using either meropenem or gentamicin appears to be an effective treatment for septic synovial structures in horses. This suggests that less critical antibiotics might be used as a viable and more judicious treatment alternative.

Cite This Article

APA
Mosichuk AP, Smith JS, Tatarniuk DM, Troy JR, Kreuder AJ. (2021). Meropenem Administered via Intravenous Regional Limb Perfusion for Orthopedic Sepsis in Horses: A Clinical Retrospective Study. Front Vet Sci, 8, 629627. https://doi.org/10.3389/fvets.2021.629627

Publication

Frontiers in veterinary science
ISSN: 2297-1769
NlmUniqueID: 101666658
Country: Switzerland
Language: English
Volume: 8
Pages: 629627
PII: 629627

Researcher Affiliations

Mosichuk, Allison P
  • College of Veterinary Medicine, Iowa State University, Ames, IA, United States.
Smith, Joseph S
  • Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.
  • Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.
Tatarniuk, Dane M
  • Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.
Troy, Jarrod R
  • Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.
Kreuder, Amanda J
  • Veterinary Microbiology and Preventive Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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Citations

This article has been cited 2 times.
  1. Loppnow Z, Kersh K, Wang C, Spaethe S, Troy J. Clinical use of antimicrobial regional limb perfusion in adult horses diagnosed with synovial sepsis or penetrating synovial wounds at a single equine referral hospital in the Midwest United States-163 cases (2010-2020). Front Vet Sci 2025;12:1504486.
    doi: 10.3389/fvets.2025.1504486pubmed: 40206250google scholar: lookup
  2. Mita H, Kuroda T, Niwa H, Tamura N, Fukuda K, Ohta M. Incidence of surgical site infection after internal fixation of the first phalangeal bone and the third metacarpal/metatarsal bone fractures in Thoroughbred racehorses. J Equine Sci 2023 Sep;34(3):61-66.
    doi: 10.1294/jes.34.61pubmed: 37781565google scholar: lookup
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