Concentration of amikacin sulphate in synovial fluid when given in combination with dexamethasone phosphate in intravenous regional limb perfusion in standing horses

Abstract

Equine septic synovitis is a potentially life-threatening disease caused most commonly by traumatic injury but can also occur following arthroscopic surgery, intra-synovial injection or in neonates, by the hematogenous route (Cousty et al., 2017). The prognosis for survival and return to an athletic career depends on multiple factors, among them: the cause of infection (Cousty et al., 2017), identification of the causative pathogen (Taylor et al., 2010), concurrent injuries, bony involvement (Kelmer et al., 2012), time from infection to initiation of treatment and the intensity of treatment (Wereszka et al., 2007).Intravenous regional limb perfusion (IVRLP) is an effective, welldescribed method of delivering high concentrations of antimicrobials to the distal limbs of horses in cases of septic synovitis in horses (Kelmer, 2016).The most commonly investigated and used antimicrobial drug in IVRLP is amikacin sulphate, a concentration-dependent aminoglycoside with suitable activity against pathogens isolated from septic synovitis in horses (Moore et al., 1992). Septic synovitis is typically accompanied by an inflammatory response creating oedema, heat and pain in the area of the affected synovial structure. Proinflammatory cytokines, such as IL-1b, TNFa and oncostatin M have