title: Evaluation of safety and pharmacokinetics of vancomycin after intravenous regional limb perfusion in horses.
abstract: OBJECTIVE
  To evaluate clinical variables, regional concentrations, and pharmacokinetics of vancomycin in the synovial fluid of distal forelimb joints of horses after IV regional limb perfusion.
  
  
  METHODS
  6 horses.
  
  
  METHODS
  Vancomycin was administered via IV regional limb perfusion to the distal portion of the forelimbs of anesthetized horses. Drug (300 mg of vancomycin hydrochloride in 60 mL of saline [0.9% NaCl] solution) was infused into 1 forelimb, whereas the contralateral limb served as a control and was perfused with 60 mL of saline solution. Solutions were injected into the lateral digital vein after digital exsanguination. Synovial fluid from the metacarpophalangeal (MTCP) and distal interphalangeal (DIP) joints and systemic blood were collected prior to perfusion and 15, 30, 45, 65, and 90 minutes after initiation of the infusion. Synovial fluid from the MTCP joint and blood were also obtained at 4, 8, 12, and 24 hours after infusion. Plasma urea and creatinine concentrations, degree of lameness, and certain clinical variables involving the MTCP joint and infusion site were assessed for 7 days. Results were compared between the vancomycin treatment and control groups.
  
  
  RESULTS
  No complications or significant differences in renal function, lameness, or clinical variables were observed between groups. Vancomycin concentrations exceeded 4 microg/mL in MTCP joints for approximately 20 hours. Higher concentrations were reached in DIP joints than in MTCP joints.
  
  
  CONCLUSIONS
  IV regional limb perfusion with 300 mg of vancomycin as a 0.5% solution was safe and may be useful in horses as treatment for distal limb infections.
authors.affiliation: Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Complutense University of Madrid, Avenida Puerta de Hierro SN, 28040 Madrid, Spain.
authors.forename: Luis M
authors.initials: LM
authors.lastname: Rubio-Martínez
authors.forename: Javier
authors.initials: J
authors.lastname: López-Sanromán
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Cruz
authors.forename: Martín
authors.initials: M
authors.lastname: Santos
authors.forename: Manuel San
authors.initials: MS
authors.lastname: Andrés
authors.forename: Fidel San
authors.initials: FS
authors.lastname: Román
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D003401:Creatine / Q000097:blood; D005552:Forelimb / Q000378:metabolism*; D005684:Gait / Q000187:drug effects; D006736:Horses / Q000378:metabolism*; D007262:Infusions, Intravenous / Q000662:veterinary; D013582:Synovial Fluid / Q000378:metabolism*; D013997:Time Factors; D014508:Urea / Q000097:blood; D014640:Vancomycin / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000633:toxicity
chemical_list: D014640:Vancomycin; D014508:Urea; D003401:Creatine