title: Pharmacokinetics, pharmacodynamics and local tolerance at injection site of marbofloxacin administered by regional intravenous limb perfusion in standing horses.
abstract: OBJECTIVE
  To evaluate pharmacokinetic-pharmacodynamic variables and local tolerance at injection-site of marbofloxacin administered via regional intravenous limb perfusion (RIVLP) in standing horses.
  
  
  METHODS
  Adult horses (n = 6).
  
  
  METHODS
  RIVLP were performed with rubber tourniquets applied to the forelimbs of standing sedated horses. Marbofloxacin (0.67 mg/kg) was randomly injected in 1 forelimb, with the contralateral limb serving as a control (0.9% NaCl solution). Samples of jugular blood and synovial fluid from the radiocarpal joint of the marbofloxacin-perfused limb were collected before and at intervals after RIVLP for determination of drug concentrations. All injection sites were evaluated before, 24 and 48 hours after RIVLP by means of ultrasonographic examination, circumferential measurements and subjective visible inflammation scores by veterinarians unaware of treatment received.
  
  
  RESULTS
  No adverse effects associated with the technique or antibiotic were observed. High marbofloxacin concentrations were obtained in the synovial fluid, AUCINF was significantly higher in synovial fluid than in plasma (78.64 ± 49.41 and 2.85 ± 0.60 µg h/mL respectively, P = .028). The efficacy indices, AUC0-24 /MIC90 and Cmaxobs/MIC90 , predicted a favorable outcome in the treatment of synovial fluid infections caused by enterobacteriaceae and Staphylococcus aureus. After RIVLP, there was no statistically significant difference between marbofloxacin-injected and control limbs for lameness, visual inflammation score, limb circumference, and ultrasonographic appearance of the veins. Marbofloxacin injected limbs had a significantly greater subcutaneous thickness, compared with control limbs.
  
  
  CONCLUSIONS
  These data suggest that RIVLP of marbofloxacin (0.67 mg/kg) could be a safe and effective method for treatment of infections of the distal portion of the limb for susceptible organisms.
authors.affiliation: Department of Equine Surgery, ONIRIS Nantes-Atlantic National College of Veterinary Medicine, Food Science and Engineering, Nantes, France. elodie.lallemand@yahoo.fr
authors.forename: Elodie
authors.initials: E
authors.lastname: Lallemand
authors.forename: Pierre
authors.initials: P
authors.lastname: Trencart
authors.forename: Carine
authors.initials: C
authors.lastname: Tahier
authors.forename: Frederic
authors.initials: F
authors.lastname: Dron
authors.forename: Angelique
authors.initials: A
authors.lastname: Paulin
authors.forename: Caroline
authors.initials: C
authors.lastname: Tessier
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000494:pharmacology; D019540:Area Under Curve; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000494:pharmacology; D005552:Forelimb / Q000378:metabolism*; D006736:Horses / Q000378:metabolism*; D007262:Infusions, Intravenous / Q000662:veterinary; D013582:Synovial Fluid / Q000378:metabolism; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; C080260:marbofloxacin