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PHARMACOKINETICS OF RECTALLY AND ORALLY ADMINISTERED LEVOFLOXACIN IN ASIAN ELEPHANTS ( ELEPHAS MAXIMUS). J Zoo Wildl Med 2023; 53:670-678. [PMID: 36640068 DOI: 10.1638/2022-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2022] [Indexed: 01/09/2023] Open
Abstract
Appropriate and effective antibiotic use is a critical component of veterinary medicine, but there are variations across species regarding dosage and administration of these drugs. Oral or rectal routes of administration are typically used in elephants, but not all medications can achieve adequate concentrations rectally. The fluoroquinolone antimicrobials are used in elephants because of their favorable antimicrobial spectrum and pharmacokinetics compared with other oral agents. They are commonly used as part of multiple antibiotic regimens for the treatment of tuberculosis (Mycobacterium tuberculosis). The objective of this study was to determine the pharmacokinetic profile of levofloxacin after oral and rectal administration in Asian elephants (Elephas maximus). Dosages of 5 mg/kg orally and 15 mg/kg rectally were evaluated in 13 Asian elephants. Blood was collected at various time points from 0 to 72 h for pharmacokinetic analysis. Pharmacokinetic parameters were determined and reached concentrations above minimum inhibitory concentrations of various bacterial organisms via both routes. A pharmacokinetic-pharmacodynamic assessment was used to estimate appropriate minimal inhibitory concentrations for bacteria that could be potentially treated with this antimicrobial. Based on these findings, levofloxacin may be a consideration for administration orally (5 mg/kg) and rectally (15 mg/kg) in Asian elephants. Antimicrobial stewardship principles, culture and susceptibility of suspected pathogens, and blood level monitoring should be used to tailor administration of levofloxacin in this species.
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Sitovs A, Sartini I, Giorgi M. Levofloxacin in veterinary medicine: a literature review. Res Vet Sci 2021; 137:111-126. [PMID: 33964616 DOI: 10.1016/j.rvsc.2021.04.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/26/2021] [Accepted: 04/27/2021] [Indexed: 01/10/2023]
Abstract
A potent third-generation antimicrobial fluoroquinolone drug, levofloxacin was introduced into human clinical practice in 1993. Levofloxacin is also used in veterinary medicine, however its use is limited: it is completely banned for veterinary use in the EU, and used extralabel in only companion animals in the USA. Since its introduction to clinical practice, many studies have been published on levofloxacin in animal species, including pharmacokinetic studies, tissue drug depletion, efficacy, and animal microbial isolate susceptibility to levofloxacin. This literature overview highlights the most clinically relevant and scientifically important levofloxacin studies linked to the field of veterinary medicine.
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Affiliation(s)
- Andrejs Sitovs
- Department of Pharmacology, Rīga Stradiņš University, Riga, Latvia.
| | - Irene Sartini
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - Mario Giorgi
- Department of Veterinary Sciences, University of Pisa, San Piero a Grado, Pisa, Italy
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Wang C, Deng L, Zhu Y, Wu K, Wei M, Huang S, Wei R, Liu W, Huang Y, Zhang H, Li D. Pharmacokinetics of levofloxacin mesylate in healthy adult giant panda after single-dose administration via different routes. J Vet Pharmacol Ther 2021; 44:644-649. [PMID: 33565110 DOI: 10.1111/jvp.12945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 11/28/2022]
Abstract
The pharmacokinetics of levofloxacin mesylate in healthy adult giant panda is unknown. In this study, the pharmacokinetics of levofloxacin after intramuscular administration at a dose of 2 mg/kg and oral administration at a dose of 3 mg/kg in healthy adult giant pandas was determined. Levofloxacin concentrations in plasma were determined using liquid chromatography. In the levofloxacin intramuscular administration group, the absorption and elimination half-lives of the drug were determined to be 0.123 (range: 0.02) hr and 5.402 (range: 0.70) hr, respectively. In the levofloxacin oral administration group, the absorption and elimination half-lives were determined to be 0.325 (range: 0.02) hr and 7.143 (range: 0.63) hr, respectively. Furthermore, the blood-drug concentration of levofloxacin was found to be above 1 μg/ml after 8 hr of intramuscular administration and above 0.5 μg/ml after 12 hr of oral administration. In this study, HPLC conditions and pretreatment methods of plasma samples were optimized and a detection method was established. Our results indicated that in healthy adult giant pandas, levofloxacin was rapidly absorbed and slowly eliminated. This study will therefore provide to be a guide in veterinary research and will be helpful in the rational use of levofloxacin in giant panda.
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Affiliation(s)
- Chengdong Wang
- China Giant Panda Conservation Research Center, Dujiangyan, China
| | - Linhua Deng
- China Giant Panda Conservation Research Center, Dujiangyan, China
| | - Yanqiu Zhu
- China Giant Panda Conservation Research Center, Dujiangyan, China
| | - Kai Wu
- China Giant Panda Conservation Research Center, Dujiangyan, China
| | - Ming Wei
- China Giant Panda Conservation Research Center, Dujiangyan, China
| | - Shang Huang
- China Giant Panda Conservation Research Center, Dujiangyan, China
| | - Rongping Wei
- China Giant Panda Conservation Research Center, Dujiangyan, China
| | - Weiping Liu
- China Giant Panda Conservation Research Center, Dujiangyan, China
| | - Yan Huang
- China Giant Panda Conservation Research Center, Dujiangyan, China
| | - Hemin Zhang
- China Giant Panda Conservation Research Center, Dujiangyan, China
| | - Desheng Li
- China Giant Panda Conservation Research Center, Dujiangyan, China
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Sartini I, Łebkowska-Wieruszewska B, Sitovs A, Lisowski A, Poapolathep A, Giorgi M. Levofloxacin pharmacokinetics and tissue residue concentrations after oral administration in Bilgorajska geese. Br Poult Sci 2020; 62:193-198. [PMID: 33121260 DOI: 10.1080/00071668.2020.1842855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
1. The aim of this study was to assess the pharmacokinetics of levofloxacin, a third-generation fluoro-quinolone antimicrobial drug, in geese (n = 26) after either single intravenous or oral administration, and to evaluate the depletion profile in goose muscle, heart, liver, kidney and lung after a single oral dose.2. The pharmacokinetic study involved 16 geese which were randomly divided into two groups (n = 8/group), the first received levofloxacin (2 mg/kg) intravenously while the second was treated with orally (5 mg/kg). The tissue depletion study involved 10 geese which were dosed orally (5 mg/kg) and two animals were killed at different time-points in order to collect the selected tissues. Levofloxacin was quantified in all the matrices tested by a validated high-performance liquid chromatography (HPLC) method, using a spectrofluorimetric detector. The pharmacokinetics were analysed using a non-compartmental model.3. Plasma concentrations were quantified after up to 24 h in animals administered intravenously and up to 48 h after oral treatment. Levofloxacin was rapidly absorbed after oral administration (Tmax = 0.38 h) showing high bioavailability (95.57 ± 20.61%). The drug showed a moderate volume of distribution (1.40 ± 0.28 ml/g) and rapid clearance (0.28 ± 0.06 ml/g/h). No statistical differences in estimates were found between the two different administration methods (P > 0.05). Drug residues were highest at 6 h and decreased constantly up to 48 h in all the selected tissues. Liver and kidney had the highest levofloxacin concentrations.4. According to the pharmacokinetic/pharmacodynamic surrogate index (AUC/MIC) the levofloxacin dose regimen (after oral administration) used in the present study could be active against bacteria at a minimum inhibitory concentration (MIC) > 0.24 μg/ml in geese. In addition, drug accumulation in the liver might be controlled using an estimated preliminary withdrawal time of 90 h.
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Affiliation(s)
- I Sartini
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - B Łebkowska-Wieruszewska
- Department of Pharmacology, Toxicology and Environmental Protection, University of Life Sciences, Lublin, Poland
| | - A Sitovs
- Department of Pharmacology, Riga Stradins University, Riga, Latvia
| | - A Lisowski
- Institute of Animal Breeding and Biodiversity Conservation, University of Life Sciences, Lublin, Poland
| | - A Poapolathep
- Department of Pharmacology, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - M Giorgi
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
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Pharmacokinetics of levofloxacin in non-lactating goats and evaluation of drug effects on resistance in coliform rectal flora. Res Vet Sci 2020; 133:283-288. [PMID: 33039880 DOI: 10.1016/j.rvsc.2020.09.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/22/2020] [Accepted: 09/25/2020] [Indexed: 11/20/2022]
Abstract
This study aimed to evaluate the pharmacokinetics/pharmacodynamics (PK/PD) of levofloxacin in non-lactating goats. Using a randomized cross-over study design, each group of animals (n = 7) received 2 mg/kg of levofloxacin intravenously (IV) and subcutaneously (SC). Plasma concentrations of levofloxacin were quantified by High Performance Liquid Chromatography with fluorescence detector (HPLC-FL). Rectal swabs were collected prior and after the treatment to identify the main bacterial population and to evaluate in vitro antimicrobial susceptibility using minimal inhibitory concentration (MIC) method. Mean values of terminal half-life for IV and SC groups were 4.56 and 5.14 h, respectively. After SC administration, the peak plasma concentration was achieved at 2 h, with a Cmax of 3681 ng/mL. Mean bioavailability was 92.12%. Bacteria isolation showed the presence of Escherichia coli (E. coli) that quickly becomes resistant to levofloxacin potentially rendering the drug ineffective. Results seem to suggest that levofloxacin is able to reach considerable plasma concentrations after both IV and SC administration, but it must be considered that both routes of administration can lead to a reversible selection of resistance in gastro-intestinal bacteria.
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Urzúa N, Messina MJ, Caverzan M, Prieto G, Lüders C, Errecalde C. Pharmacokinetics of levofloxacin after single intravenous and oral administration, and its interaction with sucralfate in mixed-breed dogs. Xenobiotica 2020; 50:1490-1493. [DOI: 10.1080/00498254.2020.1793031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Natalia Urzúa
- Departamento de Clínica Animal, Universidad Nacional de Río Cuarto, Río Cuarto, Argentina
| | - María Jimena Messina
- Departamento de Clínica Animal, Universidad Nacional de Río Cuarto, Río Cuarto, Argentina
| | - Matías Caverzan
- Departamento de Patología Animal, Facultad de Agronomía y Veterinaria, Universidad Nacional de Río Cuarto, Río Cuarto, Argentina
| | - Guillermo Prieto
- Departamento de Clínica Animal, Universidad Nacional de Río Cuarto, Río Cuarto, Argentina
| | - Carlos Lüders
- Departamento de Ciencias Veterinarias, Universidad Católica de Temuco, Temuco, Chile
| | - Carlos Errecalde
- Departamento de Clínica Animal, Universidad Nacional de Río Cuarto, Río Cuarto, Argentina
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Sitovs A, Voiko L, Kustovs D, Kovalcuka L, Bandere D, Purvina S, Giorgi M. Pharmacokinetic profiles of levofloxacin after intravenous, intramuscular and subcutaneous administration to rabbits ( Oryctolagus cuniculus). J Vet Sci 2020; 21:e32. [PMID: 32233138 PMCID: PMC7113567 DOI: 10.4142/jvs.2020.21.e32] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/20/2020] [Accepted: 01/22/2020] [Indexed: 01/05/2023] Open
Abstract
Levofloxacin pharmacokinetic profiles were evaluated in 6 healthy female rabbits after intravenous (I/V), intramuscular (I/M), or subcutaneous (S/C) administration routes at a single dose of 5 mg/kg in a 3 × 3 cross-over study. Plasma levofloxacin concentrations were detected using a validated Ultra Performance Liquid Chromatography method with a fluorescence detector. Levofloxacin was quantifiable up to 10 h post-drug administration. Mean AUC0-last values of 9.03 ± 2.66, 9.07 ± 1.80, and 9.28 ± 1.56 mg/h*L were obtained via I/V, I/M, and S/C, respectively. Plasma clearance was 0.6 mL/g*h after I/V administration. Peak plasma concentrations using the I/M and S/C routes were 3.33 ± 0.39 and 2.91 ± 0.56 μg/mL. Bioavailability values, after extravascular administration were complete, - 105% ± 27% (I/M) and 118% ± 40% (S/C). Average extraction ratio of levofloxacin after I/V administration was 7%. Additionally, levofloxacin administration effects on tear production and osmolarity were evaluated. Tear osmolarity decreased within 48 h post-drug administration. All 3 levofloxacin administration routes produced similar pharmacokinetic profiles. The studied dose is unlikely to be effective in rabbits; however, it was calculated that a daily dose of 29 mg/kg appears effective for I/V administration for pathogens with MIC < 0.5 μg/mL.
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Affiliation(s)
- Andrejs Sitovs
- Department of Pharmacology, Riga Stradins University, Riga, LV-1007, Latvia.
| | - Laura Voiko
- Clinical Institute, Faculty of Veterinary Medicine, University of Life Sciences and Technologies, Jelgava, LV-3001, Latvia
| | - Dmitrijs Kustovs
- Department of Pharmacology, Riga Stradins University, Riga, LV-1007, Latvia
| | - Liga Kovalcuka
- Clinical Institute, Faculty of Veterinary Medicine, University of Life Sciences and Technologies, Jelgava, LV-3001, Latvia
| | - Dace Bandere
- Department of Pharmaceutical Chemistry, Riga Stradins University, Riga, LV-1007, Latvia
| | - Santa Purvina
- Department of Pharmacology, Riga Stradins University, Riga, LV-1007, Latvia
| | - Mario Giorgi
- Department of Veterinary Sciences, University of Pisa, Pisa 56126, Italy
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Madsen M, Messenger K, Papich MG. Pharmacokinetics of levofloxacin following oral administration of a generic levofloxacin tablet and intravenous administration to dogs. Am J Vet Res 2019; 80:957-962. [PMID: 31556716 DOI: 10.2460/ajvr.80.10.957] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the pharmacokinetics of levofloxacin following oral administration of a generic levofloxacin tablet and IV administration to dogs and whether the achieved plasma levofloxacin concentration would be sufficient to treat susceptible bacterial infections. ANIMALS 6 healthy adult Beagles. PROCEDURES Levofloxacin was administered orally as a generic 250-mg tablet (mean dose, 23.7 mg/kg) or IV as a solution (15 mg/kg) to each dog in a crossover study design, with treatments separated by a minimum 2-day washout period. Blood samples were collected at various points for measurement of plasma levofloxacin concentration via high-pressure liquid chromatography. Pharmacokinetic analysis was performed with compartmental modeling. RESULTS After oral administration of the levofloxacin tablet, mean (coefficient of variation) peak plasma concentration was 15.5 μg/mL (23.8%), mean elimination half-life was 5.84 hours (20.0%), and mean bioavailability was 104% (29.0%). After IV administration, mean elimination half-life (coefficient of variation) was 6.23 hours (14.7%), systemic clearance was 145.0 mL/kg/h (22.2%), and volume of distribution was 1.19 L/kg (17.1%). CONCLUSIONS AND CLINICAL RELEVANCE In these dogs, levofloxacin was well absorbed when administered orally, and a dose of approximately 25 mg/kg was sufficient to reach pharmacokinetic-pharmacodynamic targets for treating infections with susceptible Enterobacteriaceae (ie, ≤ 0.5 μg/mL) or Pseudomonas aeruginosa (ie, ≤ 1 μg/mL) according to clinical breakpoints established by the Clinical and Laboratory Standards Institute.
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Sartini I, Łebkowska-Wieruszewska B, Kim TW, Lisowski A, Poapolathep A, Giorgi M. Pharmacokinetic and tissue analyses of levofloxacin in sheep (Ovis aries Linnaeus) after multiple-dose administration. Res Vet Sci 2019; 128:124-128. [PMID: 31778853 DOI: 10.1016/j.rvsc.2019.11.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/15/2019] [Accepted: 11/19/2019] [Indexed: 10/25/2022]
Abstract
The aim of this study was to assess the pharmacokinetic profile of LFX in sheep after intravenous (IV) and oral (PO) administration of 2 mg/kg LFX once a day for 5 days and to evaluate its tissue depletion in the muscles, heart, liver, lungs, and kidneys. Twenty healthy female sheep were randomly divided into two equal groups. Each group was further randomly subdivided into two equal subgroups (n = 5). Group 1 was used for blood collection and underwent a crossover design (2 × 2 Latin square). Group 2 was randomly subdivided into two equal subgroups (n = 5) for IV and PO route respectively, and used for tissue collection. A single sheep was sacrificed at each time point and the organs were harvested. Samples were analyzed using a validated HPLC method with fluorescence detection. LFX administered orally was rapidly absorbed with a peak plasma concentration of 2866 ± 239 ng/mL and an absolute oral bioavailability of 114 ± 27.7%. The pharmacokinetic estimates were comparable between PO and IV administration. According to the pharmacokinetic/pharmacodynamic surrogate index (area under the curve / minimum inhibitory concentration) of 100-125, LFX has the potential to be an effective treatment for infections caused by bacteria with a MIC of 0.049-0.061 μg/mL. LFX was detected for up to 48 h in all the tissues samples. The kidney had the highest LFX concentration after IV and PO administration. The AUCtissue/plasma ratio was lower than 1 in all tissues indicating absence of LFX tissue accumulation.
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Affiliation(s)
- Irene Sartini
- Department of Veterinary Medicine, University of Sassari, Sassari, Italy
| | - Beata Łebkowska-Wieruszewska
- Department of Pharmacology, Toxicology and Environmental Protection, University of Life Sciences, Lublin, Poland
| | - Tae Won Kim
- College of Veterinary Medicine, Chungnam National University, Daejeon, South Korea
| | - Andrzej Lisowski
- Institute of Animal Breeding and Biodiversity Conservation, University of Life Sciences, Lublin, Poland
| | - Amnart Poapolathep
- Department of Pharmacology, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - Mario Giorgi
- Department of Veterinary Sciences, University of Pisa, Via Livornese (lato monte), San Piero a Grado, 56122 Pisa, Italy.
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