ABSTRACT
Previous studies have shown that regional limb perfusion (RLP) using the palmar digital (PD) vein delivers therapeutic concentration of amikacin to the distal limb. Our hypothesis was that using the cephalic and saphenous veins for RLP will enable delivery of therapeutic concentrations of amikacin to the distal limb. Nineteen healthy horses participated in the study. The cephalic, saphenous, or PD vein was used to perfuse the limb with amikacin. Two grams of amikacin was used for RLP using the saphenous and the cephalic veins, and one gram was used in the PD vein. Synovial samples were collected from the metacarpo-/metatarsophalangeal (MCP/MTP) joint, and blood samples were collected from the jugular vein. Maximum concentration (Cmax) of amikacin in the MCP/MTP joint using the cephalic and the saphenous vein was 277 and 363 mg/L, respectively. The amikacin concentrations achieved in the synovial fluid of the MCP/MTP joint in the current study were between 69 and 91 times the minimally inhibitory concentration of common susceptible bacterial pathogens causing orthopedic infections in horses. To conclude, this study shows that use of the proximal veins for RLP to treat distal limb infections is a viable alternative to using the palmar or plantar digital vein.
Subject(s)
Amikacin/administration & dosage , Anti-Bacterial Agents/administration & dosage , Forelimb/blood supply , Horses/physiology , Animals , Drug Administration Routes , Female , MaleABSTRACT
There are no reported studies evaluating the use of erythromycin for regional limb perfusion (RLP) in horses. Our hypothesis was that using the cephalic and saphenous veins for RLP will enable delivery of therapeutic concentrations of erythromycin to the distal limb. Nineteen healthy horses participated in the study. The cephalic, saphenous or palmar digital (PD) vein was used to perfuse the limb with erythromycin. Synovial samples were collected from the metacarpo/metatarso-phalangeal (MCP/MTP) joint and blood samples were collected from the jugular vein. Maximum concentration (C(max)) of erythromycin in the MCP joint using the cephalic vein was 113 mg/L. The Cmax of erythromycin in the MTP joint using the saphenous vein was 38 mg/L. Erythromycin administered using the PD vein was not detectable in the MCP/MTP joint of four of six horses. Concentrations of erythromycin achieved in the synovial fluid of the MCP/MTP joint were between 152 and 452 times the minimal inhibitory concentration (MIC) for Rhodococcus equi (R. equi). In conclusion, the results indicate that when using the saphenous or cephalic veins for RLP, therapeutic concentrations of erythromycin in the MCP/MTP joint can be consistently reached [corrected].
Subject(s)
Anti-Bacterial Agents/administration & dosage , Erythromycin/administration & dosage , Extremities/blood supply , Infusions, Intravenous/veterinary , Jugular Veins , Saphenous Vein , Veins , Animals , Anti-Bacterial Agents/analysis , Catheters, Indwelling/veterinary , Erythromycin/analysis , Female , Horses , Infusions, Intravenous/methods , Male , Perfusion/methods , Perfusion/veterinary , Synovial Fluid/chemistryABSTRACT
The feasibility of maintaining indwelling intravenous catheters in the saphenous, cephalic or palmar digital vein of horses for seven days to infuse antimicrobial drugs was investigated in 18 horses. The horses were randomly assigned to six groups according to the vein catheterised and whether they received amikacin or erythromycin. None of the catheters was replaced more than once, and 11 of the 18 catheters remained patent for all seven days. Neither the drug administered nor the vein catheterised significantly affected the survival of the catheter. In all but three cases, complications, including local inflammation, lameness, thrombophlebitis and one severe tissue reaction to erythromycin, resolved during the seven days.
