Pharmacokinetics of intravenous clindamycin phosphate in captive Bennett's wallabies (Macropus rufogriseus)

Antimicrobial effects of clindamycin-loaded platelet-rich fibrin (PRF)

OBJECTIVES

Recent research has demonstrated that platelet-rich fibrin (PRF) is an appropriate carrier for ampicillin/sulbactam. The aim of the study was to investigate whether PRF is also a suitable bio-carrier for clindamycin (CLI).

METHODS

PRF membranes were produced from 36 patients receiving intravenous therapy with CLI (e.g. due to the diagnosis of an osteonecrosis of the jaw or infections). Concentrations of CLI in PRF membranes were measured with liquid chromatography-tandem mass spectrometry, and the antimicrobial effects were investigated in vitro in agar diffusion tests with fresh PRF and PRF stored for 24 h. Storage was performed in an incubator at 36 °C to simulate the in-vivo situation.

RESULTS

The mean concentration of CLI in plasma was 1.0 ± 0.3 μg/100 mg plasma; in resulting PRF membranes 0.7 ± 0.4 μg/100 mg PRF. Agar diffusion tests were performed with Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus mitis, Porphyromonas gingivalis, and Fusobacterium nucleatum. Mean inhibition zones, in mm, for fresh PRF were 17.3, 12.2, 18.8, 17.1, 25.8 and 18.1, 12.7, 19.2, 17.3, and 26.3 for stored PRF, respectively.

CONCLUSION

The results demonstrate that PRF is a suitable bio-carrier for CLI when administered systemically to patients. The concentration in PRF generated from patients after infusion of 600 mg CLI dose suffices to target clinically relevant bacteria.

CLINICAL RELEVANCE

Using PRF as a carrier for local antibiotic application can prevent infections in oral and maxillofacial surgery. Within the study limitations, the findings could expand the scope of PRF application by adding CLI as a new antibiotic to the spectrum of PRF therapy.

TREATMENT OF ORAL DISEASE IN EIGHT CAPTIVE BENNETT'S WALLABIES (MACROPUS RUFOGRISEUS) BETWEEN 2011 AND 2019: A CASE SERIES

Oral disease, such as endodontic disease and macropod progressive periodontal disease (MPPD), which can progress to chronic alveolar osteomyelitis (CAO), have been identified as a common source of morbidity and mortality in captive macropods. This case series reviews the diagnosis and treatment of dental disease in eight captive Bennett's wallabies (Macropus rufogriseus) over the course of an 8-yr period (2011-2019) in a zoological collection. Two wallabies were treated at four separate times, for a total of 14 anesthetized dental surgical procedures. Two wallabies died after treatment for dental disease. Endodontic disease, MPPD, and CAO were all identified and treated with extraction. Cases in which disease was identified early and treated aggressively had a good outcome with no return of clinical signs in the affected area. Several cases of extensive CAO were treated successfully with extraction and extensive debridement. One wallaby developed immune-mediated anemia, a suspected adverse drug reaction associated with prolonged administration of intravenous clindamycin.