Comparison of intraosseous or intravenous infusion for delivery of amikacin sulfate to the tibiotarsal joint of horses.
OBJECTIVE
To establish the route of infusion (IV or intraosseous) that results in the highest concentration of amikacin in the synovial fluid of the tibiotarsal joint and determine the duration of peak concentrations.


METHODS
21 horses.


METHODS
Regional perfusion of a limb on 15 horses was performed. Amikacin sulfate was infused into the saphenous vein or via intraosseous infusion into the distal portion of the tibia (1 g in 56 ml of lactated Ringer's solution) or proximal portion of the metatarsus (1 g of amikacin in 26 ml of lactated Ringer's solution). Amikacin concentrations were measured in sequential samples from tibiotarsal joint synovial fluid and serum. Samples were obtained immediately prior to release of the tourniquet and 0.5, 1, 4, 8, 12, and 24 hours after the tourniquet was released. Radiographic contrast material was infused into the same locations as the antibiotic perfusate to evaluate distribution in 6 other horses.


RESULTS
Infusion into the saphenous vein produced the highest concentration of amikacin in the tibiotarsal joint, compared with the distal portion of the tibia (mean +/- SE, 701.8 +/- 366.8 vs 203.8 +/- 64.5 microg/ml, respectively). Use of a lower volume of diluent in the proximal portion of the metatarsus produced a peak value of 72.2 +/- 23.4 microg/ml.


CONCLUSIONS
For regional perfusion of the tarsus, IV infusion is preferred to intraosseous infusion, because higher concentrations are achieved in the synovial fluid, and the procedure is easier to perform.
Scheuch
Brad C
BC
Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis 95616, USA.
Van Hoogmoed
Linda M
LM
Wilson
W David
WD
Snyder
Jack R
JR
MacDonald
Melinda H
MH
Watson
Zara E
ZE
Steffey
Eugene P
EP
D000583:Amikacin / Q000008:administration & dosage* / Q000493:pharmacokinetics; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D019540:Area Under Curve; D005260:Female; D006207:Half-Life; D006734:Horse Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism; D006736:Horses / Q000378:metabolism*; D017148:Infusions, Intraosseous / Q000662:veterinary; D007275:Injections, Intravenous / Q000662:veterinary; D007592:Joint Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism / Q000662:veterinary; D008297:Male; D011859:Radiography; D013582:Synovial Fluid / Q000378:metabolism*; D013640:Tarsal Joints / Q000378:metabolism*
D000900:Anti-Bacterial Agents; D000583:Amikacin