title: Pharmacokinetics and pharmacodynamics of enrofloxacin and a low dose of amikacin administered via regional intravenous limb perfusion in standing horses.
abstract: OBJECTIVE
  To evaluate the pharmacokinetic-pharmacodynamic parameters of enrofloxacin and a low dose of amikacin administered via regional IV limb perfusion (RILP) in standing horses.
  
  
  METHODS
  14 adult horses.
  
  
  METHODS
  Standing horses (7 horses/group) received either enrofloxacin (1.5 mg/kg) or amikacin (250 mg) via RILP (involving tourniquet application) in 1 forelimb. Samples of interstitial fluid (collected via implanted capillary ultrafiltration devices) from the bone marrow (BMIF) of the third metacarpal bone and overlying subcutaneous tissues (STIF), blood, and synovial fluid of the radiocarpal joint were collected prior to (time 0) and at intervals after tourniquet release for determination of drug concentrations. For pharmacokinetic-pharmacodynamic analyses, minimum inhibitory concentrations (MICs) of 16 microg/mL (amikacin) and 0.5 microg/mL (enrofloxacin) were applied.
  
  
  RESULTS
  After RILP with enrofloxacin, 3 horses developed vasculitis. The highest synovial fluid concentrations of enrofloxacin and amikacin were detected at time 0; median values (range) were 13.22 microg/mL (0.254 to 167.9 microg/mL) and 26.2 microg/mL (5.78 to 50.0 microg/mL), respectively. Enrofloxacin concentrations exceeded MIC for approximately 24 hours in STIF and synovial fluid and for 36 hours in BMIF. After perfusion of amikacin, concentrations greater than the MIC were not detected in any samples. Effective therapeutic concentrations of enrofloxacin were attained in all samples.
  
  
  CONCLUSIONS
  In horses with orthopedic infections, RILP of enrofloxacin (1.5 mg/kg) should be considered as a treatment option. However, care must be taken during administration. A dose of amikacin > 250 mg is recommended to attain effective tissue concentrations via RILP in standing horses.
authors.affiliation: Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA.
authors.forename: Alberto
authors.initials: A
authors.lastname: Parra-Sanchez
authors.forename: Joel
authors.initials: J
authors.lastname: Lugo
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Boothe
authors.forename: Earl M
authors.initials: EM
authors.lastname: Gaughan
authors.forename: R Reid
authors.initials: RR
authors.lastname: Hanson
authors.forename: Sue
authors.initials: S
authors.lastname: Duran
authors.forename: James K
authors.initials: JK
authors.lastname: Belknap
mesh_terms: D000583:Amikacin / Q000008:administration & dosage / Q000493:pharmacokinetics*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics*; D019540:Area Under Curve; D001853:Bone Marrow / Q000378:metabolism; D000077422:Enrofloxacin; D024841:Fluoroquinolones / Q000493:pharmacokinetics*; D005552:Forelimb; D006736:Horses / Q000378:metabolism*; D008826:Microbial Sensitivity Tests; D011897:Random Allocation; D013582:Synovial Fluid / Q000378:metabolism; D014018:Tissue Distribution
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D000077422:Enrofloxacin; D000583:Amikacin