ArticleBMC veterinary research2025
Pharmacokinetics, pharmacodynamics, and local tolerance at injection site of penicillin and gentamicin administered by intravenous regional limb perfusion in standing horses: comparison between weightbearing and flexed limbs.
Article in BMC veterinary research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIntravenous regional limb perfusion (IVRLP) of antibiotics is a therapeutic method used to treat distal limb infections in horses. The objectives of this study were to determine the pharmacokinetic parameters and tolerance of sodium benzylpenicillin (NaBP) administered via IVRLP; to compare the feasibility, tolerance, and efficacy of performing IVRLP on a flexed limb versus a weightbearing limb; and to predict the efficacy of IVRLP using gentamicin or NaBP. A prospective crossover study was conducted with six horses, each undergoing four phases of antibiotic infusion (gentamicin at 2.2 mg/kg vs. NaBP at 7,333 IU/kg of BP) and limb positioning (weightbearing vs. flexed). Each antibiotic administration was followed by serial synovial and blood sampling to assess antibiotic concentrations. Inflammation and sensitivity to palpation were evaluated at both the injection site and the sampled joint. A pharmacokinetic/pharmacodynamic analysis was carried out to predict the efficacy of IVRLP by estimating area under the concentration-time curve to minimum inhibitory concentration (AUC/MIC) index values for various minimum inhibitory concentrations (MICs).
resultsHigh synovial concentrations of NaBP and gentamicin were achieved, with notable variability between horses. NaBP IVRLP was well tolerated, although cephalic vein inflammation scores were significantly higher following NaBP infusion than gentamicin (p = 3.4 × 10
conclusionsThese findings suggest that daily IVRLP with NaBP (7,333 IU/kg of BP) could be an effective treatment for distal limb infections caused by susceptible bacteria with a MIC of ≤ 2 µg/mL, with only mild local inflammation at the injection site. IVRLP with 2.2 mg/kg gentamicin appears effective for treating infections involving susceptible bacteria with an MIC of ≤ 16 µg/mL. Performing IVRLP on a weightbearing limb resulted in higher antibiotic exposure in the metacarpophalangeal joint and better tolerance than the flexed limb method.
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