FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Can Vet J / Pharmacokinetics of regional limb perfusion using a combinat...
The Canadian veterinary journal = La revue veterinaire canadienne2019; 60(3); 294-299;

Pharmacokinetics of regional limb perfusion using a combination of amikacin and penicillin in standing horses.

Abstract: The objectives of this study were to evaluate the compatibility and the pharmacokinetic properties of combined amikacin and penicillin administration by intravenous regional limb perfusion (IVRLP) in horses. A tourniquet was applied proximal to the carpus of 7 clinically healthy adult horses and 2 g of amikacin and 10 × 10 IU of penicillin (100 mL total volume) were sequentially injected into the cephalic vein just distal to the tourniquet. Synovial samples were collected from the joint at several times after injection. All samples were analyzed for amikacin and penicillin concentration. The mean maximum concentration (C) of both amikacin and penicillin was over 10-fold the relevant minimal inhibitory concentration (MIC) for all horses and remained above those MICs for at least 24 hours. The results of this study indicate that combining amikacin with penicillin during IVRLP in normal horses delivers high therapeutic synovial concentrations of both drugs. . Les objectifs de cette étude consistaient à évaluer la compatibilité et les propriétés pharmacocinétiques de l’administration combinée d’amikacine et de pénicilline par perfusion intraveineuse régionale des membres (PIRM) chez les chevaux. Un tourniquet a été appliqué proximalement au carpe de sept chevaux adultes en bonne santé clinique et 2 g d’amikacine et 10 × 10 UI de pénicilline (volume total de 100 ml) ont été injectés en séquence dans la veine céphalique légèrement distale au tourniquet. Des échantillons synoviaux ont été prélevés de l’articulation plusieurs fois après l’injection. Tous les échantillons ont été analysés pour la concentration d’amikacine et de pénicilline. La concentration maximale moyenne (C) de l’amikacine et de la pénicilline était plus de 10 fois supérieure à la concentration inhibitrice minimale (CIM) pertinente pour tous les chevaux et est demeurée au-dessus de ces CIM pendant au moins 24 heures. Les résultats de cette étude indiquent que la combinaison de l’amikacine avec la pénicilline durant la PIRM chez des chevaux en santé offre des concentrations synoviales thérapeutiques élevées des deux médicaments.(Traduit par Isabelle Vallières).
Get Full Text
Publication Date: 2019-03-16 PubMed ID: 30872853PubMed Central: PMC6380264
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • 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.

The research article discusses a study that examined the effectiveness and interaction of amikacin and penicillin when delivered through intravenous regional limb perfusion (IVRLP) in horses, with the results indicating this method resulted in therapeutic concentrations of both drugs in joint fluid.

Objective and Methodology of the Study

  • The primary goal of this study was to analyse both the compatibility and the pharmacokinetic characteristics—that is, how the body absorbs, distributes, metabolizes, and eliminates the drugs—of combined amikacin and penicillin when administered to horses through IVRLP.
  • The method used to deliver the drugs involved applying a tourniquet proximal to the carpus, or wrist joint, of seven clinically healthy adult horses. Thereafter, 2g of amikacin and 10 x 10IU of penicillin were sequentially injected into the cephalic vein, which is located just below the tourniquet. Following this, synovial fluid samples were collected from the joint at various time intervals after injection.
  • All samples collected were characterized by their respective concentrations of amikacin and penicillin.

Results and Conclusions of the Study

  • Results from the synovial fluid samples indicated that the mean maximum concentration (Cmax) of both amikacin and penicillin was over ten times the minimal inhibitory concentration (MIC) for all horses under examination. The MIC is the lowest concentration of a drug that will inhibit the visible growth of a microorganism, thus indicating the drug’s effectiveness at fighting infections.
  • The concentration of both drugs in the horses’ synovial fluid stayed above the relevant MIC for a period of at least 24 hours. This finding highlights the persistent therapeutic efficacy of this method of drug delivery.
  • The results overall demonstrate that combining amikacin with penicillin and administering the drugs via IVRLP in healthy horses delivers high therapeutic synovial concentrations of both drugs. Such high concentrations indicate that this method could be effective in treating joint infections in horses.

Cite This Article

APA
Dahan R, Oreff GL, Tatz AJ, Raz T, Britzi M, Kelmer G. (2019). Pharmacokinetics of regional limb perfusion using a combination of amikacin and penicillin in standing horses. Can Vet J, 60(3), 294-299.

Publication

The Canadian veterinary journal = La revue veterinaire canadienne
ISSN: 0008-5286
NlmUniqueID: 0004653
Country: Canada
Language: English
Volume: 60
Issue: 3
Pages: 294-299

Researcher Affiliations

Dahan, Roee
  • Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, the Hebrew University of Jerusalem, Israel (Dahan, Oreff, Tatz, Raz, Kelmer); Kimron Veterinary Institute, National Residue Control Laboratory, Bet Dagan, Israel (Britzi).
Oreff, Gil L
  • Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, the Hebrew University of Jerusalem, Israel (Dahan, Oreff, Tatz, Raz, Kelmer); Kimron Veterinary Institute, National Residue Control Laboratory, Bet Dagan, Israel (Britzi).
Tatz, Amos J
  • Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, the Hebrew University of Jerusalem, Israel (Dahan, Oreff, Tatz, Raz, Kelmer); Kimron Veterinary Institute, National Residue Control Laboratory, Bet Dagan, Israel (Britzi).
Raz, Tal
  • Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, the Hebrew University of Jerusalem, Israel (Dahan, Oreff, Tatz, Raz, Kelmer); Kimron Veterinary Institute, National Residue Control Laboratory, Bet Dagan, Israel (Britzi).
Britzi, Malka
  • Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, the Hebrew University of Jerusalem, Israel (Dahan, Oreff, Tatz, Raz, Kelmer); Kimron Veterinary Institute, National Residue Control Laboratory, Bet Dagan, Israel (Britzi).
Kelmer, Gal
  • Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, the Hebrew University of Jerusalem, Israel (Dahan, Oreff, Tatz, Raz, Kelmer); Kimron Veterinary Institute, National Residue Control Laboratory, Bet Dagan, Israel (Britzi).

MeSH Terms

  • Amikacin
  • Animals
  • Anti-Bacterial Agents
  • Forelimb
  • Horses
  • Penicillins
  • Perfusion / veterinary
  • Synovial Fluid

References

This article includes 32 references
  1. Rubio-Martínez LM, Elmas CR, Black B, Monteith G. Clinical use of antimicrobial regional limb perfusion in horses: 174 cases (1999-2009).. J Am Vet Med Assoc 2012 Dec 15;241(12):1650-8.
    pubmed: 23216042doi: 10.2460/javma.241.12.1650google scholar: lookup
  2. Kelmer G. Regional limb perfusion in horses.. Vet Rec 2016 Jun 4;178(23):581-4.
    pubmed: 27256262doi: 10.1136/vr.i3082google scholar: lookup
  3. Rubio-Martínez LM, Cruz AM. Antimicrobial regional limb perfusion in horses.. J Am Vet Med Assoc 2006 Mar 1;228(5):706-12, 655.
    pubmed: 16506931doi: 10.2460/javma.228.5.706google scholar: lookup
  4. Perez F, Hujer AM, Hujer KM, Decker BK, Rather PN, Bonomo RA. Global challenge of multidrug-resistant Acinetobacter baumannii.. Antimicrob Agents Chemother 2007 Oct;51(10):3471-84.
    pmc: PMC2043292pubmed: 17646423doi: 10.1128/aac.01464-06google scholar: lookup
  5. Rahal JJ Jr. Antibiotic combinations: the clinical relevance of synergy and antagonism.. Medicine (Baltimore) 1978 Mar;57(2):179-95.
    pubmed: 202836
  6. Hardefeldt LY, Browning GF, Thursky K, Gilkerson JR, Billman-Jacobe H, Stevenson MA, Bailey KE. Antimicrobials used for surgical prophylaxis by equine veterinary practitioners in Australia.. Equine Vet J 2018 Jan;50(1):65-72.
    pubmed: 28608525doi: 10.1111/evj.12709google scholar: lookup
  7. Nieto JE, Trela J, Stanley SD, Yamout S, Snyder JR. Pharmacokinetics of a combination of amikacin sulfate and penicillin G sodium for intravenous regional limb perfusion in adult horses.. Can J Vet Res 2016 Jul;80(3):230-5.
    pmc: PMC4924558pubmed: 27408337
  8. Moore RM, Schneider RK, Kowalski J, Bramlage LR, Mecklenburg LM, Kohn CW. Antimicrobial susceptibility of bacterial isolates from 233 horses with musculoskeletal infection during 1979-1989.. Equine Vet J 1992 Nov;24(6):450-6.
    pubmed: 1459058doi: 10.1111/j.2042-3306.1992.tb02875.xgoogle scholar: lookup
  9. Kelmer G, Tatz A, Bdolah-Abram T. Indwelling cephalic or saphenous vein catheter use for regional limb perfusion in 44 horses with synovial injury involving the distal aspect of the limb.. Vet Surg 2012 Nov;41(8):938-43.
    pubmed: 22809228doi: 10.1111/j.1532-950x.2012.01006.xgoogle scholar: lookup
  10. Kelmer G, Bell GC, Martin-Jimenez T, Saxton AM, Catasus C, Elliot SB, Meibohm B. Evaluation of regional limb perfusion with amikacin using the saphenous, cephalic, and palmar digital veins in standing horses.. J Vet Pharmacol Ther 2013 Jun;36(3):236-40.
    pubmed: 22607056doi: 10.1111/j.1365-2885.2012.01414.xgoogle scholar: lookup
  11. Zantingh AJ, Schwark WS, Fubini SL, Watts AE. Accumulation of amikacin in synovial fluid after regional limb perfusion of amikacin sulfate alone and in combination with ticarcillin/clavulanate in horses.. Vet Surg 2014 Mar;43(3):282-8.
    pubmed: 24467593doi: 10.1111/j.1532-950x.2014.12119.xgoogle scholar: lookup
  12. Moser DK, Schoonover MJ, Holbrook TC, Payton ME. Effect of Regional Intravenous Limb Perfusate Volume on Synovial Fluid Concentration of Amikacin and Local Venous Blood Pressure in the Horse.. Vet Surg 2016 Oct;45(7):851-858.
    pubmed: 27509840doi: 10.1111/vsu.12521google scholar: lookup
  13. Godfrey JL, Hardy J, Cohen ND. Effects of regional limb perfusion volume on concentrations of amikacin sulfate in synovial and interstitial fluid samples from anesthetized horses.. Am J Vet Res 2016 Jun;77(6):582-8.
    pubmed: 27227495doi: 10.2460/ajvr.77.6.582google scholar: lookup
  14. Oreff GL, Dahan R, Tatz AJ, Raz T, Britzi M, Kelmer G. The Effect of Perfusate Volume on Amikacin Concentration in the Metacarpophalangeal Joint Following Cephalic Regional Limb Perfusion in Standing Horses.. Vet Surg 2016 Jul;45(5):625-30.
    pubmed: 27273831doi: 10.1111/vsu.12490google scholar: lookup
  15. Durward-Akhurst SA, Mair TS, Boston R, Dunkel B. Comparison of two antimicrobial regimens on the prevalence of incisional infections after colic surgery.. Vet Rec 2013 Mar 16;172(11):287.
    pubmed: 23268187doi: 10.1136/vr.101186google scholar: lookup
  16. Stewart AA, Goodrich LR, Byron CR, Evans RB, Stewart MC. Antimicrobial delivery by intrasynovial catheterisation with systemic administration for equine synovial trauma and sepsis.. Aust Vet J 2010 Apr;88(4):115-23.
    pubmed: 20402698doi: 10.1111/j.1751-0813.2010.00553.xgoogle scholar: lookup
  17. Prescott JF, Nicholson VM. The effects of combinations of selected antibiotics on the growth of Corynebacterium equi.. J Vet Pharmacol Ther 1984 Mar;7(1):61-4.
    pubmed: 6561258doi: 10.1111/j.1365-2885.1984.tb00880.xgoogle scholar: lookup
  18. Wallace SM, Chan LY. In vitro interaction of aminoglycosides with beta-lactam penicillins.. Antimicrob Agents Chemother 1985 Aug;28(2):274-81.
    pmc: PMC180231pubmed: 3834833doi: 10.1128/aac.28.2.274google scholar: lookup
  19. Dahan R, Britzy G, Sutton GA, Shir S, Kelmer G. Evaluation of the pharmacokinetic properties of a combination of marbofloxacin and imipenem administered by regional limb perfusion to standing horses.. J Equine Vet Sci 2017;53:1–7.
  20. Bassage Ii LH, Ross MW. Diagnostic analgesia. In: Ross MW, Dyson SJ, editors. Diagnosis and Management of Lameness in the Horse. 2nd ed. St. Louis, Missouri: WB Saunders; 2003. pp. 93–124.
  21. Jacks SS, Giguère S, Nguyen A. In vitro susceptibilities of Rhodococcus equi and other common equine pathogens to azithromycin, clarithromycin, and 20 other antimicrobials.. Antimicrob Agents Chemother 2003 May;47(5):1742-5.
    pmc: PMC153307pubmed: 12709351doi: 10.1128/aac.47.5.1742-1745.2003google scholar: lookup
  22. Adamson PJ, Wilson WD, Hirsh DC, Baggot JD, Martin LD. Susceptibility of equine bacterial isolates to antimicrobial agents.. Am J Vet Res 1985 Feb;46(2):447-50.
    pubmed: 3994111
  23. Hyde RM, Lynch TM, Clark CK, Slone DE, Hughes FE. The influence of perfusate volume on antimicrobial concentration in synovial fluid following intravenous regional limb perfusion in the standing horse.. Can Vet J 2013 Apr;54(4):363-7.
    pmc: PMC3595939pubmed: 24082163
  24. Thauvin C, Eliopoulos GM, Wennersten C, Moellering RC Jr. Antagonistic effect of penicillin-amikacin combinations against enterococci.. Antimicrob Agents Chemother 1985 Jul;28(1):78-83.
    pmc: PMC176314pubmed: 3929683doi: 10.1128/aac.28.1.78google scholar: lookup
  25. McKellar QA, Sanchez Bruni SF, Jones DG. Pharmacokinetic/pharmacodynamic relationships of antimicrobial drugs used in veterinary medicine.. J Vet Pharmacol Ther 2004 Dec;27(6):503-14.
    pubmed: 15601444doi: 10.1111/j.1365-2885.2004.00603.xgoogle scholar: lookup
  26. Sutton DG, Preston T, Christley RM, Cohen ND, Love S, Roussel AJ. The effects of xylazine, detomidine, acepromazine and butorphanol on equine solid phase gastric emptying rate.. Equine Vet J 2002 Jul;34(5):486-92.
    pubmed: 12358052doi: 10.2746/042516402776117818google scholar: lookup
  27. Pille F, De Baere S, Ceelen L, Dewulf J, Croubels S, Gasthuys F, De Backer P, Martens A. Synovial fluid and plasma concentrations of ceftiofur after regional intravenous perfusion in the horse.. Vet Surg 2005 Nov-Dec;34(6):610-7.
    pubmed: 16343149doi: 10.1111/j.1532-950x.2005.00095.xgoogle scholar: lookup
  28. Craig WA. Pharmacokinetic/pharmacodynamic parameters: rationale for antibacterial dosing of mice and men.. Clin Infect Dis 1998 Jan;26(1):1-10; quiz 11-2.
    pubmed: 9455502doi: 10.1086/516284google scholar: lookup
  29. Gunderson BW, Ross GH, Ibrahim KH, Rotschafer JC. What do we really know about antibiotic pharmacodynamics?. Pharmacotherapy 2001 Nov;21(11 Pt 2):302S-318S.
    pubmed: 11714222doi: 10.1592/phco.21.18.302s.33905google scholar: lookup
  30. Caron JP, Bolin CA, Hauptman JG, Johnston KA. Minimum inhibitory concentration and postantibiotic effect of amikacin for equine isolates of methicillin-resistant Staphylococcus aureus in vitro.. Vet Surg 2009 Jul;38(5):664-9.
    pubmed: 19573072doi: 10.1111/j.1532-950x.2009.00551.xgoogle scholar: lookup
  31. Weese JS, Rousseau J, Willey BM, Archambault M, McGeer A, Low DE. Methicillin-resistant Staphylococcus aureus in horses at a veterinary teaching hospital: frequency, characterization, and association with clinical disease.. J Vet Intern Med 2006 Jan-Feb;20(1):182-6.
    pubmed: 16496939doi: 10.1892/0891-6640(2006)20[182:msaiha]2.0.co;2google scholar: lookup
  32. Brilene T, Soeorg H, Kiis M, Sepp E, Kõljalg S, Lõivukene K, Jürna-Ellam M, Kalinina J, Stšepetova J, Metsvaht T, Lutsar I. In vitro synergy of oxacillin and gentamicin against coagulase-negative staphylococci from blood cultures of neonates with late-onset sepsis.. APMIS 2013 Sep;121(9):859-64.
    pubmed: 23294372doi: 10.1111/apm.12048google scholar: lookup

Citations

This article has been cited 6 times.
  1. 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.
    doi: 10.1371/journal.pone.0265971pubmed: 35363825google scholar: lookup
  2. 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.
    doi: 10.1186/s12917-021-03052-zpubmed: 34702265google scholar: lookup
  3. 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.
    doi: 10.3389/fvets.2021.629627pubmed: 33842571google scholar: lookup
  4. Guillot M, Mespoulhes-Rivière C, Bousquet-Mélou A, Lacroix MZ, Roques BB, Lallemand EA. Pharmacokinetics, pharmacodynamics, and local tolerance at injection site of penicillin and gentamicin administered by intravenous regional limb perfusion in standing horses: comparison between weightbearing and flexed limbs. BMC Vet Res 2025 Nov 7;21(1):650.
    doi: 10.1186/s12917-025-04936-0pubmed: 41204239google scholar: lookup
  5. 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
  6. 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
Subscribe to our newsletter
Join 99,359 horse owners like you who receive our email updates on horse health and nutrition.