title: Comparison of intraosseous or intravenous infusion for delivery of amikacin sulfate to the tibiotarsal joint of horses.
abstract: 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.
authors.affiliation: Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis 95616, USA.
authors.forename: Brad C
authors.initials: BC
authors.lastname: Scheuch
authors.forename: Linda M
authors.initials: LM
authors.lastname: Van Hoogmoed
authors.forename: W David
authors.initials: WD
authors.lastname: Wilson
authors.forename: Jack R
authors.initials: JR
authors.lastname: Snyder
authors.forename: Melinda H
authors.initials: MH
authors.lastname: MacDonald
authors.forename: Zara E
authors.initials: ZE
authors.lastname: Watson
authors.forename: Eugene P
authors.initials: EP
authors.lastname: Steffey
mesh_terms: 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*
chemical_list: D000900:Anti-Bacterial Agents; D000583:Amikacin