Work performed at the College of Veterinary Medicine, University of Georgia. Funded in part by 2008 Diplomate Clinical Research Grant awarded by the ACVS Foundation. Presented in part at the ACVS Veterinary Symposium, Washington, DC, October 8–10, 2009.
Original Article - Clinical
Effect of Experimentally Induced Synovitis on Amikacin Concentrations after Intravenous Regional Limb Perfusion
Article first published online: 8 SEP 2011
© Copyright 2011 by The American College of Veterinary Surgeons
Volume 40, Issue 7, pages 891–897, October 2011
How to Cite
Beccar-Varela, A. M., Epstein, K. L. and White, C. L. (2011), Effect of Experimentally Induced Synovitis on Amikacin Concentrations after Intravenous Regional Limb Perfusion. Veterinary Surgery, 40: 891–897. doi: 10.1111/j.1532-950X.2011.00875.x
- Issue published online: 5 OCT 2011
- Article first published online: 8 SEP 2011
- Manuscript Accepted: JAN 2011
- Manuscript Received: MAY 2010
- ACVS Foundation
To determine the effects of experimentally induced synovitis of the radiocarpal joint on the intra-articular pharmacokinetics and pharmacodynamics of amikacin after intravenous regional limb perfusion (IVRLP).
Randomized crossover experimental design.
Adult horses (n = 8).
Horses were randomly assigned into 2 trials: synovitis and no-synovitis. Radiocarpal joint synovitis was induced with lipopolysaccharide 6 hours before IVRLP. IVRLP (5-mg/kg amikacin qs 60 mL) was performed with a pneumatic tourniquet under general anesthesia. Synovial fluid was obtained before and 0.5, 1, 3, 5, 12, 24, 48 hours after IVRLP. Amikacin concentrations at each time point and pharmacokinetic values were compared between synovitis and no-synovitis trials with Student's t-test.
Amikacin synovial fluid concentrations indicated suspected tourniquet failure on 3 occasions (2 synovitis, 1 no-synovitis) on 3 different horses. Data from both trials in these 3 horses were excluded from further analysis. Observed time to maximal concentration (Tmax; mean ± SD = 54 ± 13.42 min) was reached earlier in synovitis joints (5/5, 30 min) than in no-synovitis joints (1/5, 30 min and 4/5, 1 h; P = .0476) (P = .0161). Mean observed maximal concentration (Cmax) was higher in synovitis joints (144.48 ± 43.17 μg/mL) than in no-synovitis joints (60.02 ± 28.81 μg/mL; P = .0301). The recommended Cmax: minimum inhibitory concentration ratio of 8 was achieved in 3/5 of the successfully perfused joints with induced synovitis, but this ratio was not achieved in any of the clinically normal joints.
Synovitis of the radiocarpal joint resulted in an earlier observed Tmax and higher observed Cmax of intra-articular amikacin after IVRLP compared with normal joints.