Comparison of two indirect techniques for local delivery of a high dose of an antimicrobial in the distal portion of forelimbs of horses

Abstract

Both techniques reliably achieved synovial fluid concentrations of amikacin consistent with concentration-dependent killing for bacteria commonly encountered in horses with septic arthritis. Esmarch tourniquets were effective for both delivery techniques in standing horses.

Clinical and pharmacokinetic effects of regional or general anaesthesia on intravenous regional limb perfusion with amikacin in horses

“…concentrations as observed in previous studies [12,19,20]. This variability might in part be explained by the fact that the dose of amikacin was fixed and not corrected for the animal's weight similar to clinical practice and previous studies [21]. Blood contamination of the synovial fluid samples might have affected the measured intrasynovial amikacin concentrations [21].…”

“…This variability might in part be explained by the fact that the dose of amikacin was fixed and not corrected for the animal's weight similar to clinical practice and previous studies [21]. Blood contamination of the synovial fluid samples might have affected the measured intrasynovial amikacin concentrations [21]. However, arthrocentesis of the middle carpal joint is regarded as easy [11] and all arthrocenteses were performed by the primary author in a similar manner.…”

“…pressure before leakage to the systemic circulation will result and this is a reflection of tourniquet efficacy [22]. Sudden weight shifts on the front limbs of a horse can double intravascular pressure distal to the tourniquet [21], which might exceed the maximum venous pressure and cause leakage of the perfusate from the isolated area. This has been suggested as a possible cause of perfusate leakage [3,4,12].…”

“…A shortcoming of this study is that although fluorescence polarisation immunoassay has been used previously to measure amikacin on equine synovial samples [10,12,16,19,21,23], an in-house validation of the assay was not performed.…”

Evaluation of regional limb perfusion with amikacin using the saphenous, cephalic, and palmar digital veins in standing horses

“…Previous studies have shown that RLP using the palmar digital (PD) vein delivers therapeutic concentrations of antimicrobial drugs to the distal portion of the limb (Murphey et al, 1999;Rubio-Martinez et al, 2005a;Errico et al, 2008). Multiple treatments using RLP are often needed to resolve persistent infection, and premature termination of RLP is likely to occur because of loss of venous access to the PD vein (Butt et al, 2001;Mattson et al, 2004).…”