Determination of Synovial Fluid and Serum Concentrations, and Morphologic Effects of Intraarticular Ceftiofur Sodium in Horses

Abstract

Ceftiofur sodium may be an acceptable broad spectrum antimicrobial to administer IA in septic arthritic equine joints.

Reinfected Revised TKA Resolves With an Aggressive Protocol and Antibiotic Infusion

“…Antibiotics injected into synovial joints are absorbed in a manner similar to antibiotics injected intramuscularly and produce similar serum concentration [13,27], so some peripheral therapeutic antibiotic effect would be expected. Antibiotics injected directly into the joint produce concentrations substantially higher in the adjacent bone than can be achieved with intravenous administration [17,35]. This suggests local antibiotic concentration in the bone and soft tissue beyond the synovial membrane would more likely be bactericidal with intraarticular than with intravenous administration of antibiotics.…”

“…Intravenous antibiotics achieve adequate joint levels only briefly [13,17,22,23,26,35]; and antibiotic-loaded cement spacers are depleted of available antibiotics after 3 to 7 days and thereafter become a potential nidus for growth of infecting organisms [2,26,32].…”

Methicillin-resistant Staphylococcus aureus in TKA Treated With Revision and Direct Intraarticular Antibiotic Infusion

“…In cases of resistant bacteria or gram-negative organisms, the levels are too low to be effective [26]. Intraarticular injection of third-generation cephalosporins in horses results in concentrations in synovial fluid in the range of 5,000 to 10,000 lg/mL, while intravenous administration resulted in concentrations of 7-10 lg/mL [22]. Antibiotic concentrations achieved with antibiotic-loaded cement spacers can be high early, but decrease rapidly after the first 24 hours [2,21,35,43].…”

“…Furthermore, the low concentration of antibiotics at the surface of these spacers promotes the growth of antibioticresistant bacteria [27,29]. The other common mode of delivery of antibiotics to infected joints, intravenous administration, generally achieves low synovial fluid concentration [18,22,31,32,35,47], and it is especially low for drugs that have poor soft tissue penetration such as gentamicin [35].…”

The Pharmacokinetics of the Weakly Protein-Bound Anionic Compound Diatrizoate in Serum and Synovial Fluid of the Horse

“…The objective was to develop a pharmacokinetic model for DTZ allowing joint disappearance kinetics to be estimated from serum appearance kinetics. Further, the study was designed to enable calculation of the relative joint exposure after intravenous (iv) and IA drug administration (F iv/IA ), a parameter for which only few estimates are available in the literature (18).…”