Intramuscular administration of sodium benzylpenicillin in horses as an alternative to procaine benzylpenicillin

Olsén, Lena; Bremer, Hanna; Olofsson, Karin; Bröjer, Johan; Bondesson, Ulf; Bergh, Anna; Nostell, Katarina; Broström, Hans; Bengtsson, Björn; Ingvast-Larsson, C.

doi:10.1016/j.rvsc.2013.01.019

Cited by 3 publications

(12 citation statements)

References 21 publications

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“…Intramuscular injections [28] Microchip insertion [20] Induced back pain [29] Induced carpal osteoarthritis [30] Celiotomy [31]…”

Section: Pain Statesmentioning

confidence: 99%

“…Most devices used to measure MNTs are reported to be stable and do not need constant recalibration [54,55]. However, a few manufacturers do provide a standard weight [28,40] or recommend using a manometer [15] for calibration of the instrument prior to recording. While drift in measured MNT values could be expected, the clinical relevance is likely negligible as there are no accepted normative MNT values across body regions within horses [24].…”

Section: Calibrationmentioning

confidence: 99%

“…Once horses have become accustomed to the MNT technique, they often stand quietly with predictable and uniform endpoints readily identified. However, in some painful horses the anxiety of pressure testing in a region of increased sensitivity may prevent the application of pressure algometry (Table 5) [20,28,30].…”

Section: Acclimatizationmentioning

confidence: 99%

“…Microchip insertion [20] 1 of 18 (6%) Hostile to all handling procedures Hypersensitivity to pressure Intramuscular neck injections [28] 1 of 8 (12%) Anxiety (repeated injections) Thoracic limbs-carpal osteoarthritis [30] 4 of 24 (17%) Refused to stand (carpal pain)…”

Section: Application Prevalence Intolerancementioning

confidence: 99%

“…Local anesthetics typically produce less MNT variability (e.g., CV < 0.20), compared to baseline values (e.g., CV > 0.50; Table 12) [35,36]. Conversely, painful conditions are often associated with increased MNT variability [28]. In horses with sacroiliac region pain the mean left-right differences were 8.1 ± 8.2 N/cm 2 (CV = 101%), compared to a comparable control group with MNTs of 5.1 ± 3.4 N/cm 2 (CV = 66%) [18].…”

Section: Nociceptive Repeatabilitymentioning

confidence: 99%

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Pressure Algometry for the Detection of Mechanical Nociceptive Thresholds in Horses

Haussler

2020

Animals

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The clinical assessment of pain is subjective; therefore, variations exist between practitioners in their ability to identify and localize pain. Due to differing interpretations of the signs or severity of pain equine practitioners may assign varying levels of clinical significance and treatment options. There is a critical need to develop better tools to qualify and quantify pain in horses. Palpation is the most common method to detect local tenderness or sensitivity. To quantify this applied pressure, pressure algometry has been used to gradually apply pressure over specified landmarks until an avoidance response is noted, which is defined as the mechanical nociceptive threshold (MNT). Numerous studies have used pressure algometry in different applications to measure MNTs in horses. There is an acute need to establish normative values within different body regions and to develop standardized methods of testing MNTs to better guide practitioners in the diagnosis and treatment of pain. The aim of this systematic review was to summarize the evidence for the use of pressure algometry in horses. There is good evidence that pressure algometry is a repeatable, semi-objective method that can be used in a wide array of clinical and research applications to assess MNTs in horses.

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“…Intramuscular injections [28] Microchip insertion [20] Induced back pain [29] Induced carpal osteoarthritis [30] Celiotomy [31]…”

Section: Pain Statesmentioning

confidence: 99%

Section: Calibrationmentioning

confidence: 99%

Section: Acclimatizationmentioning

confidence: 99%

Section: Application Prevalence Intolerancementioning

confidence: 99%

Section: Nociceptive Repeatabilitymentioning

confidence: 99%

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Pressure Algometry for the Detection of Mechanical Nociceptive Thresholds in Horses

Haussler

2020

Animals

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Pharmacokinetic–pharmacodynamic cutoff values for benzylpenicillin in horses to support the establishment of clinical breakpoints for benzylpenicillin antimicrobial susceptibility testing in horses

Lallemand,

Bousquet-Mélou,

Chapuis

et al. 2023

Front. Microbiol.

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IntroductionThe aim of this international project was to establish a species-specific Clinical Breakpoint for interpretation of Antimicrobial Susceptibility Testing of benzylpenicillin (BP) in horses.MethodsA population pharmacokinetic model of BP disposition was developed to compute PK/PD cutoff values of BP for different formulations that are commonly used in equine medicine around the world (France, Sweden, USA and Japan). Investigated substances were potassium BP, sodium BP, procaine BP, a combination of procaine BP and benzathine BP and penethamate, a prodrug of BP. Data were collected from 40 horses that provided 63 rich profiles of BP corresponding to a total of 1022 individual BP plasma concentrations.ResultsA 3-compartment disposition model was selected. For each of these formulations, the PK/PD cutoff was estimated for different dosage regimens using Monte Carlo simulations. The fAUC/MIC or fT>MIC were calculated with a free BP fraction set at 0.4. For fAUC/MIC, a target value of 72 h (for a 72h treatment) was considered. For fT>MIC, efficacy was assumed when free plasma concentrations were above the explored MIC (0.0625-2 mg/L) for 30 or 40 % of the dosing interval. For continuous infusion, a fT>MIC of 90 % was considered. It was shown that a PK/PD cutoff of 0.25 mg/L can be achieved in 90 % of horses with routine regimen (typically 22,000 IU/kg or 12.4 mg/kg per day) with IM procaine BP once a day (France, Japan, Sweden but not USA1) and with IM sodium BP at 14.07 mg/kg, twice a day or IV sodium BP infusion of 12.4 mg/kg per day. In contrast, penethamate and the combination of procaine BP and benzathine BP were unable to achieve this PK/PD cutoff not even an MIC of 0.125 mg/L.DiscussionThe PK/PD cutoff of 0.25 mg/L is one dilution lower than the clinical breakpoint released by the CLSI (0.5 mg/ L). From our simulations, the CLSI clinical breakpoint can be achieved with IM procaine BP twice a day at 22,000 IU i.e. 12.4 mg/kg.

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Predicted efficacy and tolerance of different dosage regimens of benzylpenicillin in horses based on a pharmacokinetic study with three IM formulations and one IV formulation

Ferran,

Roques,

Chapuis

et al. 2024

Front. Vet. Sci.

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IntroductionBenzylpenicillin (BP) is a first-line antibiotic in horses but there are discrepancies between manufacturers and literature recommendations regarding dosing regimen. Objectives of this study were to evaluate pharmacokinetics and local tolerance of four different formulations of BP in adult horses, and to suggest optimized dosing regimen according to the formulation.MethodsA cross-over design was used in 3 phases for the intramuscular injection of three different products: procaine BP alone, procaine BP/ benzathine BP combination or penethamate hydriodide were administered IM in the gluteal muscles of 6 horses for 3 days. Single IV administration of sodium BP was performed to the same horses with a dose of 22,000 IU BP/kg bwt 39 weeks after last IM injection. BP plasma concentrations were determined by UPLC assay coupled with mass spectrometry and a PK/PD analysis was conducted to predict the efficacy of various dosing regimens by estimating values of the fT>MIC index for different minimum inhibitory concentrations (MIC). Tolerance at the site of IM injection was monitored by creatine kinase activity quantified with a validated chemistry system and clinical scorings.Results and discussionExcept one neurological reaction following one administration of penethamate hydriodide, the tolerance was good. Procaine BP alone, procaine BP/benzathine BP combination or penethamate hydriodide intramuscular administrations at a dosage of 22,000 IU BP/kg bwt q24h for 5 days would yield plasma concentrations that should be effective against bacteria with MIC of ≤0.256, 0.125 or 0.064 mg/L respectively. Of all the tested treatments, the use of a sodium BP by IV Constant Rate Infusion (CRI) for 10 hours a day was deemed to be the most efficient. All the formulations tested in this study are adequate to treat infections with susceptible Streptococcus equi.

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Intramuscular administration of sodium benzylpenicillin in horses as an alternative to procaine benzylpenicillin

Cited by 3 publications

References 21 publications

Pressure Algometry for the Detection of Mechanical Nociceptive Thresholds in Horses

Pressure Algometry for the Detection of Mechanical Nociceptive Thresholds in Horses

Pharmacokinetic–pharmacodynamic cutoff values for benzylpenicillin in horses to support the establishment of clinical breakpoints for benzylpenicillin antimicrobial susceptibility testing in horses

Predicted efficacy and tolerance of different dosage regimens of benzylpenicillin in horses based on a pharmacokinetic study with three IM formulations and one IV formulation

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