Continuous infusion of gentamicin into the tarsocrural joint of horses

Timothy B. Lescun Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.

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Stephen B. Adams Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.

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 DVM, MS
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Ching Ching Wu Departments of Veterinary Pathobiology , School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.

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Robert P. Bill Departments of Basic Medical Sciences, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.

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Abstract

Objective—To develop a method for continuous infusion of gentamicin into the tarsocrural joint of horses, to determine pharmacokinetics of gentamicin in synovial fluid of the tarsocrural joint during continuous infusion, and to evaluate effects of continuous infusion of gentamicin on characteristics of the synovial fluid.

Animals—12 healthy adult horses.

Procedure—An infusion catheter consisting of flow control tubing connected to a balloon infuser was used. Gentamicin solution (100 mg/ml) was infused in the right tarsocrural joint and balanced electrolyte solution was infused in the left tarsocrural joint for 5 days. Synovial fluid and serum gentamicin concentrations were measured by use of a fluorescence polarization immunoassay.

Results—17 of the 24 (71%) infusion catheters initially placed functioned without complications for the entire 5-day infusion period. Median gentamicin concentration in synovial fluid from treated joints during the 5-day infusion period ranged from 287.5 to 982 μg/ml. Median serum gentamicin concentration during this period ranged from 2.31 to 2.59 μg/ml. Mean (± SD) elimination half-life and total clearance of gentamicin from the synovial fluid were 6.25 ± 1.01 hours and 1.52 ± 0.96 ml/min, respectively.

Conclusions and Clinical Relevance—An infusion catheter can be used for continuous infusion of gentamicin into the tarsocrural joints of horses for up to 5 days. At a gentamicin dosage of 0.17 ± 0.02 mg/kg/h, continuous intra-articular infusion results in synovial fluid gentamicin concentrations greater than 100 times the minimal inhibitory concentration reported for common equine pathogens. (Am J Vet Res 2000;61:407–412)

Abstract

Objective—To develop a method for continuous infusion of gentamicin into the tarsocrural joint of horses, to determine pharmacokinetics of gentamicin in synovial fluid of the tarsocrural joint during continuous infusion, and to evaluate effects of continuous infusion of gentamicin on characteristics of the synovial fluid.

Animals—12 healthy adult horses.

Procedure—An infusion catheter consisting of flow control tubing connected to a balloon infuser was used. Gentamicin solution (100 mg/ml) was infused in the right tarsocrural joint and balanced electrolyte solution was infused in the left tarsocrural joint for 5 days. Synovial fluid and serum gentamicin concentrations were measured by use of a fluorescence polarization immunoassay.

Results—17 of the 24 (71%) infusion catheters initially placed functioned without complications for the entire 5-day infusion period. Median gentamicin concentration in synovial fluid from treated joints during the 5-day infusion period ranged from 287.5 to 982 μg/ml. Median serum gentamicin concentration during this period ranged from 2.31 to 2.59 μg/ml. Mean (± SD) elimination half-life and total clearance of gentamicin from the synovial fluid were 6.25 ± 1.01 hours and 1.52 ± 0.96 ml/min, respectively.

Conclusions and Clinical Relevance—An infusion catheter can be used for continuous infusion of gentamicin into the tarsocrural joints of horses for up to 5 days. At a gentamicin dosage of 0.17 ± 0.02 mg/kg/h, continuous intra-articular infusion results in synovial fluid gentamicin concentrations greater than 100 times the minimal inhibitory concentration reported for common equine pathogens. (Am J Vet Res 2000;61:407–412)

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