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the last number of years. 7 – 9 IVRLPs are commonly performed with a concentration-dependent antibiotic, most frequently amikacin sulfate, but have also been reported with time-dependent antibiotics. 3 , 7 , 10 – 13 Both historic and recent studies

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in American Journal of Veterinary Research

the urine yielded growth of Pseudomonas aeruginosa (38,000 CFUs/mL), which subsequent testing revealed was susceptible only to amikacin, gentamicin, imipenemcilastatin, and ticarcillin–clavulanic acid. Results of a urinalysis revealed an absence of

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in Journal of the American Veterinary Medical Association

for susceptible pathogens is considered ≤ 4 ug/mL, 8 ug/mL is considered intermediate susceptibility, and ≥ 16 ug/mL is considered resistant for amikacin. 19 Therefore, concentrations of 40 μg/mL for susceptible bacteria, 80 μg/mL for intermediate

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in American Journal of Veterinary Research

administration is to optimize the C max of the drug at the site of infection by use of the highest possible nontoxic dose. 4 , 18 In a 2018 study, 20 it took 15 minutes for amikacin to reach its C max in the synovial fluid of the DIPJ of horses following

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in American Journal of Veterinary Research

orthopedic infections in horses are targeted by those drugs. Furthermore, regional treatment decreases the risk of nephrotoxicosis associated with systemic use of those agents. 5 The dose of amikacin routinely administered by RILP to horses in clinical

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in American Journal of Veterinary Research

sulfate and amikacin sulfate. 8,9 These factors make it difficult to achieve adequate MICs of the antimicrobial drugs through systemic administration. 8,9 Intravenous regional limb perfusion with antimicrobial drugs is an effective adjunctive treatment

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in American Journal of Veterinary Research

bone. 1–6 These concentrations reportedly exceed 50 times the MICs of antimicrobials against common equine bacterial pathogens. 3,5,6 The MIC of amikacin against most equine bacterial pathogens is 16 μg/mL. 3,5,6 Aminoglycosides such as amikacin are

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in American Journal of Veterinary Research

study reported here was to determine the Cmax in the DIP joint and the Tmax after IVRLP of 2 g of amikacin sulfate by use of a cephalic vein. We hypothesized that Tmax would be less than the typical duration of tourniquet application of 30 minutes

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in American Journal of Veterinary Research

suspected infections in the distal aspect of limbs. 1–4 Various drug dosages, injection volumes, and techniques for IVRLP have been proposed and evaluated experimentally. 1–11 Aminoglycosides, specifically amikacin, are the most commonly used type of

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in American Journal of Veterinary Research

Abstract

Objective—To determine disposition kinetics of amikacin in neonatal foals administered high doses at extended intervals.

Animals—7 neonatal foals.

Procedure—Amikacin was administered (21 mg/kg, IV, q 24 h) for 10 days. On days 1, 5, and 10, serial plasma samples were obtained for measurement of amikacin concentrations and determination of pharmacokinetics.

Results—Mean ± SD peak plasma concentrations of amikacin extrapolated to time 0 were 103.1 ± 23.4, 102.9 ± 9.8, and 120.7 ± 17.9 µg/mL on days 1, 5, and 10, respectively. Plasma concentrations at 1 hour were 37.5 ± 6.7, 32.9 ± 2.6, and 30.6 ± 3.5 µg/mL; area under the curve (AUC) was 293.0 ± 61.0, 202.3 ± 40.4, and 180.9 ± 31.2 (µg · h)/mL; elimination half-life (t1/2β) was 5.33, 4.08, and 3.85 hours; and clearance was 1.3 ± 0.3, 1.8 ± 0.4, and 2.0 ± 0.3 mL/(min · kg), respectively. There were significant increases in clearance and decreases in t1/2β, AUC, mean residence time, and plasma concentrations of amikacin at 1, 4, 8, 12, and 24 hours as foals matured.

Conclusions and Clinical Relevance—Once-daily administration of high doses of amikacin to foals resulted in high peak plasma amikacin concentrations, high 1-hour peak concentrations, and large values for AUC, consistent with potentially enhanced bactericidal activity. Age-related findings suggested maturation of renal function during the first 10 days after birth, reflected in enhanced clearance of amikacin. High-dose, extended-interval dosing regimens of amikacin in neonatal foals appear rational, although clinical use remains to be confirmed. (Am J Vet Res 2004;65:473–479)

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in American Journal of Veterinary Research