Pharmacokinetics of a combination of amikacin sulfate and penicillin G sodium for intravenous regional limb perfusion in adult horses

Jorge Nieto, Jan Trela, Scott D Stanley, Sawsan Yamout, Jack R. Snyder

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The aim of this study was to determine the pharmacokinetics of amikacin and penicillin G sodium when administered in combination as an intravenous regional limb perfusion (IVRLP) to horses. Seven healthy adult horses underwent an IVRLP in the cephalic vein with 2 g of amikacin sulfate and 10 mill IU of penicillin G sodium diluted to 60 mL in 0.9% saline. A pneumatic tourniquet set at 450 mmHg was left in place for 30 min. Synovial fluid was collected from the metacarpophalangeal joint 35 min and 2, 6, 12, and 24 h after infusion of the antimicrobials. Concentrations of amikacin and penicillin in synovial fluid were quantitated by liquid chromatography tandem-mass spectrometry analysis. Therapeutic concentrations of amikacin and penicillin for equine-susceptible pathogens were achieved in the synovial fluid. Maximum synovial concentrations (Cmax) (mean ± SE) for amikacin and penicillin were 132 ± 33 μg/mL and 8474 ± 5710 ng/mL, respectively. Only 3 horses had detectable levels of penicillin at 6 h and 1 at the 12 h sample. The combination of amikacin with penicillin G sodium via IVDLP resulted in reported therapeutic concentrations of both antibiotics in the synovial fluid. The Cmax:MIC (minimum inhibitory concentration) ratio for amikacin was 8:1 and Time. MIC for penicillin was 6 h. At 24 h, the mean concentration of amikacin was still above 4 μg/mL. Terminal elimination rate constants (T1/2 lambdaz) were 13.6 h and 2.8 h for amikacin and penicillin, respectively. The use of IVDLP with penicillin may therefore not be practical as rapid clearance of penicillin from the synovial fluid requires frequent perfusions to maintain acceptable therapeutic concentrations.

Original languageEnglish (US)
Pages (from-to)230-235
Number of pages6
JournalCanadian Journal of Veterinary Research
Volume80
Issue number3
StatePublished - Jul 1 2016

Fingerprint

amikacin
benzylpenicillin
Penicillin G
Amikacin
limbs (animal)
penicillins
pharmacokinetics
Horses
Penicillins
sulfates
Extremities
Pharmacokinetics
Perfusion
synovial fluid
horses
Synovial Fluid
therapeutics
tourniquets
Metacarpophalangeal Joint
Tourniquets

ASJC Scopus subject areas

  • veterinary(all)

Cite this

Pharmacokinetics of a combination of amikacin sulfate and penicillin G sodium for intravenous regional limb perfusion in adult horses. / Nieto, Jorge; Trela, Jan; Stanley, Scott D; Yamout, Sawsan; Snyder, Jack R.

In: Canadian Journal of Veterinary Research, Vol. 80, No. 3, 01.07.2016, p. 230-235.

Research output: Contribution to journalArticle

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