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Pharmacokinetics of ceftiofur in the metacarpophalangeal joint after standing intravenous regional limb perfusion in horses.

Abstract: This study investigated the pharmacokinetics of ceftiofur after intravenous regional limb perfusion (IVRLP). Six horses were involved in 3 IVRLP sessions. For each session, operators with varying clinical experience placed the tourniquet. A wide-rubber tourniquet was applied in the antebrachium as 2 g of ceftiofur in a total volume of 100 mL was injected into the cephalic vein. Plasma and metacarpophalangeal synovial fluid samples were obtained to evaluate perfusate leakage and synovial fluid concentrations of ceftiofur over 24 h. Overall, mean plasma concentrations were not significantly different before and after tourniquet removal. Mean synovial fluid ceftiofur concentrations were significantly higher 5 min and 8 h after tourniquet removal 24 h, after which values above the minimum inhibitory concentration (MIC) (1 μg/mL) were not detected. Concentrations above the MIC were detected in 72% and 50% of the horses at 5 min and 8 h, respectively. Overall, higher synovial fluid concentrations were obtained for the operator with the most recent clinical experience performing IVRLP. . Cette étude a examiné la pharmacocinétique du ceftiofur après perfusion intraveineuse loco-régionale des membres (PLR). Six chevaux ont participé à trois séances PLR. Pour chaque séance, un opérateur d’expérience clinique différente a placé le garrot. Un garrot large en caoutchouc a été appliqué dans l’avant-bras tandis que 2 g de ceftiofur dans un volume total de 100 mL ont été injectés dans la veine céphalique. Des échantillons de plasma et de liquide synovial métacarpophalangien ont été prélevés pour évaluer les fuites de perfusion et les concentrations de liquide synovial de ceftiofur au fil du temps. Dans l’ensemble, les concentrations plasmatiques moyennes n’étaient pas significativement différentes avant et après le retrait du garrot. Les concentrations moyennes de ceftiofur dans le liquide synovial étaient significativement plus élevées 5 min et 8 h après le retrait du garrot par rapport à 24 h, où les valeurs supérieures à la CMI (1 μg/mL) n’étaient pas détectées. Des concentrations supérieures à la CMI ont été détectées chez 72 % et 50 % des chevaux à 5 min et 8 h, respectivement. Des concentrations plus élevées de liquide synovial ont été obtenues pour l’opérateur avec une expérience clinique plus récente sur PLR.(Traduit par les auteurs).
Publication Date: 2021-09-04 PubMed ID: 34475583PubMed Central: PMC8360312
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  • Journal Article
  • Research Support
  • Non-U.S. Gov't

Summary

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The research explores how the antibiotic ceftiofur behaves in horse bodies when administered using a specific method called intravenous regional limb perfusion (IVRLP), focusing on effects in the horse’s metacarpophalangeal joint (part of horse’s front leg). The study also considered how operator experience influenced the results.

Study Methodology

  • The study involved six horses and each underwent IVRLP three times. Ceftiofur was used because of its common use in equine medicine for treating infections.
  • The injections were administered by operators with different levels of clinical experience, to study any potential variation it may cause. The tourniquet placement, an important step in IVRLP, was hence subject to varying execution.
  • A tourniquet was used in the horse’s forelimb (antebrachium), and 2 grams of ceftiofur dissolved in 100 mL of solution was infused into the cephalic vein.
  • At specific intervals post-infusion, the researchers took plasma and synovial fluid samples from the metacarpophalangeal joint (a joint situated in horse’s lower limb) for analysis. The goal was to track the presence and concentration of ceftiofur in these fluids, over a 24-hour period.

Findings and Implications

  • Generally, there was no meaningful difference in ceftiofur plasma concentrations before and after tourniquet removal. The tourniquet, which is intended to restrict the infused drug to a specific body part, thus worked as expected.
  • However, the ceftiofur concentration in synovial fluid was significantly higher 5 minutes and 8 hours after the tourniquet was removed, as compared to 24 hours. In fact, after 24 hours, the concentration was largely below the minimum inhibitory concentration (MIC – a concentration at which a drug still has its intended effects). The high initial concentrations could mean that ceftiofur rapidly diffuses into the synovial fluid.
  • Interestingly, the percentage of horses with ceftiofur synovial fluid concentrations above the MIC at 5 minutes and 8 hours (72% and 50% respectively) indicates the antibiotic impacts vary across different individuals and over time.
  • Last but not least, the study found that the operator with the most recent clinical experience in performing IVRLP achieved higher ceftiofur concentrations in the synovial fluid. This might suggest that precision in administering the drug can play a big role in its effectiveness.

Overall, this research provides valuable insights into the behavior of ceftiofur in horses’ bodies when delivered via IVRLP, and underlines the importance of operator skill in this procedure. These findings can be useful for developing more effective treatment protocols in equine medicine.

Cite This Article

APA
Bonilla AG, Causeret L, Torrent-Crosa A. (2021). Pharmacokinetics of ceftiofur in the metacarpophalangeal joint after standing intravenous regional limb perfusion in horses. Can Vet J, 62(9), 975-981.

Publication

ISSN: 0008-5286
NlmUniqueID: 0004653
Country: Canada
Language: English
Volume: 62
Issue: 9
Pages: 975-981

Researcher Affiliations

Bonilla, Alvaro G
  • Département de sciences cliniques, Faculté de médecine vétérinaire, Université de Montréal, St-Hyacinthe, Québec.
Causeret, Lisa
  • Département de sciences cliniques, Faculté de médecine vétérinaire, Université de Montréal, St-Hyacinthe, Québec.
Torrent-Crosa, Albert
  • Département de sciences cliniques, Faculté de médecine vétérinaire, Université de Montréal, St-Hyacinthe, Québec.

MeSH Terms

  • Amikacin
  • Animals
  • Anti-Bacterial Agents
  • Cephalosporins
  • Forelimb
  • Horses
  • Metacarpophalangeal Joint
  • Perfusion / veterinary
  • Synovial Fluid

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