Synovial fluid pharmacokinetics of tulathromycin, gamithromycin and florfenicol after a single subcutaneous dose in cattle

Pharmacokinetics of florfenicol in serum and seminal plasma in beef bulls

The objectives of this study were to compare the serum and seminal plasma pharmacokinetic profiles of florfenicol (FLO) and florfenicol amine (FLA) after the administration of FLO either by IM or SC routes in beef bulls. Four clinically healthy Hereford bulls underwent a comprehensive physical exam, including breeding soundness examination, CBC, and chemistry profile panel. Bulls were healthy and classified satisfactory potential breeders. In one group (n = 2), a single dose of FLO was administered SC in the middle of the neck at a dose of 40 mg/kg of body weight. In the second group (n = 2), a single dose was administered IM in the muscles of the neck at a dose of 20 mg/kg. Concentrations of FLO and FLA in serum and seminal plasma were determined by ultra-high-performance liquid chromatography coupled to tandem mass spectrometry (UHPLC-MS/MS). Blood and semen samples were collected before the administration of FLO and at 12, 24, 36, 48, 72, 96, 120, 144, and 168 h after injection. The blood was collected from the coccygeal vessels, and semen was collected by electroejaculation. All samples were immediately refrigerated, processed within the first hour after collection, and finally stored at -80 °C. The mean level of total FLO in serum was higher when administered by the SC route (1,415.5 ng/mL) than by the IM route (752.4 ng/mL; P = 0.001). Differences were observed between the percentage of FLA in serum (1.8%; ranging from 1.3 to 2.9) and in seminal plasma (27.5%; ranging from 15.9 to 34.2; P = 0.0001). The mean level (±SD) of FLA was higher in seminal plasma compared to serum (467 ± 466 ng/mL and 18 ± 16 ng/mL, respectively; P = 0.001). The mean level of total FLO in seminal plasma was 1,454.8 ng/mL for the SC route and 1,872.9 ng/mL for the IM route without differences between the two routes (P = 0.51). Differences in the mean level of total FLO between serum and seminal plasma were detected (1,187 ± 2,069 ng/mL and 1,748 ± 1,906 ng/mL, respectively; P = 0.04). From the present investigation, it was concluded that FLO is a suitable antibiotic based on its pharmacokinetic attributes and may be employed for the treatment of bull genital infections when its use is indicated. To study the pharmacokinetics of FLO in seminal plasma, the analysis of FLA should be incorporated.

Comprehensive Outcomes Affected by Antimicrobial Metaphylaxis of Feedlot Calves at Medium-Risk for Bovine Respiratory Disease from a Randomized Controlled Trial

The objectives were to evaluate the effects of metaphylaxis (META) and pull-and-treat (PT) programs on health, antimicrobial use, beef production, economics, and greenhouse gas emissions in cattle at medium risk for bovine respiratory disease (BRD). A randomized complete block design was used at two US commercial feedlots. Steers and heifers [2366 total; 261 (±11.0) kg initial weight] were blocked by sex and feedlot arrival, and allocated to one of two pens within a block (16 pens total, eight blocks). Pens were randomly assigned to treatment: META, tulathromycin injection at initial processing; or PT, tulathromycin injection only for first clinical BRD treatment. Data were analyzed with linear and generalized linear mixed models. There was greater BRD morbidity in PT than META cattle (17.2% vs. 7.3% respectively; p < 0.01), and greater total mortality (2.5% vs. 1.1% respectively; p = 0.03). Per animal enrolled, 1.1 antimicrobial doses were used for META compared to 0.2 for PT (p < 0.01). Per animal enrolled, final live (p = 0.04) and carcass (p = 0.08) weights were greater for META than PT; however, net returns ($/animal) were not significantly different (p = 0.71). Compared to PT, total lifetime estimated CO₂ equivalent emissions from production were reduced by 2% per unit of live weight for META (p = 0.09). While antimicrobial use was reduced with PT, there may be substantial negative impacts on other outcomes if META was not used in this type of cattle population.

Synovial and Systemic Pharmacokinetics of Florfenicol and PK/PD Integration against Streptococcus suis in Pigs

Florfenicol is a member of the phenicol group, a broad-spectrum antibacterial agent. It has been used for a long time in veterinary medicine, but there are some factors regarding its pharmacokinetic characteristics that have yet to be elucidated. The aim of our study was to describe the pharmacokinetic profile of florfenicol in synovial fluid and plasma of swine after intramuscular (i.m.) administration. In addition, the dosage regimen of treatment of arthritis caused by S. suis was computed for florfenicol using pharmacokinetic/pharmacodynamic (PK/PD) indices. As the first part of our investigation, the pharmacokinetic (PK) parameters of florfenicol were determined in the plasma and synovial fluid of six pigs. Following drug administration (15 mg/kg_bw, intramuscularly), blood was drawn at the following times: 10, 20, 30, 40, 50 and 60 min, 2, 3, 4, 5, 6, 7, 8, 12, 24, 48 and 72 h; synovial fluid samples were taken after 1, 2, 3, 4, 6, 8, 12, 24, 48 and 72 h. The concentration of florfenicol was determined by a validated liquid chromatography-mass spectrometry (LC-MS/MS) method via multiple reaction monitoring (MRM) modes. As the second part of our research, minimum inhibitory concentration (MIC) values of florfenicol were determined in 45 S. suis strains isolated from clinical samples collected in Hungary. Furthermore, a strain of S. suis serotype 2 (SS3) was selected, and killing-time curves of different florfenicol concentrations (0.5 µg/mL, 1 µg/mL and 2 µg/mL) were determined against this strain. Peak concentration of the florfenicol was 3.58 ± 1.51 µg/mL in plasma after 1.64 ± 1.74 h, while it was 2.73 ± 1.2 µg/mL in synovial fluid 3.4 ± 1.67 h after administration. The half-life in plasma was found to be 17.24 ± 9.35 h, while in synovial fluid it was 21.01 ± 13.19 h. The area under the curve (AUC_24h) value was 54.66 ± 23.34 μg/mL·h for 24 h in plasma and 31.24 ± 6.82 μg/mL·h for 24 h in synovial fluid. The drug clearance scaled by bioavailability (Cl/F) in plasma and synovial fluid was 0.19 ± 0.08 L/h/kg and 0.29 ± 0.08 L/h/kg, respectively. The mean residence time (MRT) in plasma and synovial fluid was 24.0 ± 13.59 h and 27.39 ± 17.16 h, respectively. The steady-state volume of distribution (V_ss) in plasma was calculated from Cl/F of 0.19 ± 0.08 L/h/kg, multiplied by MRT of 24.0 ± 13.59 h. For the PK/PD integration, average plasma and synovial fluid concentration of florfenicol was used in a steady-state condition. The obtained MIC₅₀ value of the strains was 2.0 µg/mL, and MIC₉₀ proved to be 16.0 µg/mL. PK/PD integration was performed considering AUC_24h/MIC breakpoints that have already been described. This study is the first presentation of the pharmacokinetic behavior of florfenicol in swine synovia as well as a recommendation of extrapolated critical MICs of S. suis for therapeutic success in the treatment of S. suis arthritis in swine, but it should be noted that this requires a different dosage regimen to that used in authorized florfenicol formulations.

Pharmacokinetics of tulathromycin on plasma and semen of beef bulls

The objective of this investigation was to evaluate the pharmacokinetic parameters of tulathromycin in plasma and semen of beef bulls after administering a single sc dose at two different sites in the neck. Four Simmental bulls with excellent temperament received a comprehensive physical exam that included breeding soundness examination. In addition, blood was collected and analyzed for CBC and chemical panel in order to rule out any subclinical liver or kidney disease. All bulls were diagnosed as healthy and satisfactory potential breeders. The mean plasma levels of tulathromycin for the two neck sites of sc administration were not different between posterior aspect of the ear where it attaches to the head (RP; regio parotidea; 77.9 ± 43.3 ng/mL; X ± SD) and to the middle of the neck (RC; regio collis lateralis; 73.7 ± 39.7 ng/mL; P = 0.84). The mean seminal plasma levels of tulathromycin after administration in the RP was 608 ± 374 ng/mL and for RC was 867 ± 599 ng/mL without differences between both sites (P = 0.29). The mean level of tulathromycin in plasma was 75.8 ± 40.2 ng/mL, which was lower than mean seminal plasma levels of 781 ± 482 ng/mL (P = 0.001). The plasma peak tulathromycin concentration (C_max) was 160 ± 27 ng/mL at 21 ± 6 h (T_max) post-administration. The seminal plasma C_max was 1539 ± 44.4 ng/mL at 33.00 ± 18.00 h (T_max) post-administration. The C_max between plasma and seminal plasma were different (P = 0.008) without any differences in T_max between plasma and seminal plasma (P = 0.35). The terminal half-life for plasma tulathromycin (81.4 ± 27.6 h) showed a tendency to be shorter than in seminal plasma (114.7 ± 21.7; P = 0.10). The plasma area under the curve concentration time from the first to the last sample (AUC_0-last) was 15,440 ± 1717 ng/mL/h, which was significatively smaller compared with 171,071 ± 58,556 ng/mL/h for seminal plasma AUC_0-last (P = 0.01). The plasma means residence time from the first to the last sample (MRT_0-last) was 89.3 ± 5.1 h and it was shorter than for seminal plasma of 96.6 ± 5.0 h (P = 0.05). From the present investigation, it was concluded that tulathromycin is a suitable antibiotic based in its pharmacokinetic properties that could be used for treatment of bull genital infections when its application is indicated.

Intra-articular injection in the hind limb joints of dromedary camels (Camelus dromedarius) using anatomical and arthrographic-guided landmarks

Background and Aim:

A healthy joint is an important structure for the proper movement of the camel limb. Intra-articular (IA) injection is frequently used in veterinary practice for diagnostic and therapeutic purposes of joint injuries. Thus, the current study aimed to describe the injection of the hindlimb joints in dromedary camels based on the anatomical and arthrographic-guided landmarks.

Materials and Methods:

Eighteen orthopedically sound adult camels (mean±standard deviation age: 78±12 months) of both sexes were included in this study. Three camels were euthanized to identify anatomical features in the hindlimb joints and related structures. IA injections were performed in the hindlimbs of 5 camel cadavers to evaluate the optimal IA injection site, which was confirmed by arthrography. The optimized IA injection technique was applied in 10 live camels and confirmed by arthrocentesis and arthrography. For each joint, injection criteria (number of attempts, difficulty of injection, and successful injection) were assessed, scored, and statistically compared to the other joints.

Results:

The summation of IA injection criteria scores was significantly higher (p<0.05) in the femorotibial, femoropatellar, tibiotarsal, fetlock, pastern, and coffin joints in comparison to the hip joint.

Conclusion:

Anatomical and arthrographic-guided techniques offer considerable advantages for the characterization of anatomical landmarks and selection of the appropriate IA injection site in the hindlimb in dromedary camels. Furthermore, a reference approach for camels was established that is different from the approach for cattle and horses.

Pharmacokinetics and Pharmacodynamics of Gamithromycin Treatment of Pasteurella multocida in a Murine Lung Infection Model

Gamithromycin is approved for the treatment and prevention of bovine respiratory disease (BRD), which is caused mainly by Mannheimia haemolytica, Pasteurella multocida, Histophilus somni, and Mycoplasma species. In this study, multiple dosage regimens were administered to the neutropenic mouse lung infection model in order to investigate the pharmacokinetic/pharmacodynamic (PK/PD) parameters of gamithromycin treatment of P. multocida and to further define the PK/PD parameter that best correlates with the efficacy of gamithromycin against P. multocida. The PK characteristics of gamithromycin were analyzed after a single subcutaneous (s.c.) injection (1, 3, 6, and 9 mg/kg). The concentration–time profiles of unbound (f) gamithromycin in plasma samples were analyzed by non-compartmental analysis. The main PK parameters of gamithromycin for the area under the concentration–time curve from 0 to 24 h (f AUC_0–24) and the peak drug concentration (f C_max) values ranged from 0.86 to 8.42 µg·h/ml and from 0.55 to 5.69 µg/ml, respectively. The PD values were calculated based on multiple s.c. injections over 24 h (1, 3, 6, and 9 mg/kg at 6, 8, 12, and 24 h, respectively; total dosage 1–36 mg/ kg). The minimum inhibitory concentration (MIC) of gamithromycin against P. multocida in mice serum was 0.15 μg/ml. Analysis of PK/PD indices using the inhibitory effect E_max model indicated a strong correlation (R² = 0.9624) between the f AUC_0–24/MIC ratio and various antibacterial effects. The area under the unbound concentration–time curve over 24 h to MIC (f AUC_0–24/MIC) predicted for bacteriostatic action, 1-log₁₀ reduction, 2-log₁₀ reduction, and 3-log₁₀ reduction were 56.77, 90.18, 143.06, and 239.44 h, respectively. These in vivo data may facilitate gamithromycin dosage optimization against P. multocida in veterinary medicine.

Factors associated with septic arthritis of the distal interphalangeal joint in beef cattle: A case-control study

Lameness in cattle is a welfare concern and is associated with important economic losses in beef cattle operations. Infection of the distal interphalangeal joint (DIJ) results in severe lameness and if left untreated carries a poor prognosis. Diagnosis of DIJ infection is challenging in the field. The aim of this study was to determine factors associated with septic arthritis of the DIJ in beef cattle. Thirty-nine beef cattle with a complaint of single-foot lameness were used in this study. History and lameness examination data were recorded and analyzed. Radiographic changes and cytology of synovial fluid of the affected DIJ were used to define the presence (cases) or absence (controls) of DIJ infection. Asymmetric swelling at the coronary band of the affected foot and a lameness score of ≥4/5 significantly increased the odds (odds ratio [OR]=63.2 and OR=120, respectively) of diagnosis of septic arthritis of the DIJ in beef cattle with a single-foot lameness compared to cattle with no asymmetry of the coronary band or lameness scores <3. Routine lameness examination findings could be used in the field to rapidly recognize infection of the DIJ in lame beef cattle.

Management of Polyarthritis Affecting Sea Turtles at Kélonia, the Reunion Island Sea Turtle Observatory (2013-17)

All sea turtle species are listed on the Red List of the International Union for the Conservation of Nature due to multiple threats. Among these, disease is a frequent cause of stranded sea turtles encountered in rehabilitation centers. Since 2013, we found joint swelling in 13 sea turtles belonging to all four sea turtle species submitted to the Kélonia Sea Turtle Observatory of Reunion Island, France. Affected sea turtles presented with lameness, anorexia, and lethargy. Polyarthritis was radiographically confirmed and lesions were characterized by progressive osteolysis of bones surrounding joints. Anterior flippers were affected in all cases and posterior flippers were also involved in some cases. We isolated several bacterial agents from blood and synovial fluid. We attempted a collective treatment with injectable florfenicol, based on sensitivity results, which was continued for 4 wk and then as needed based on radiographic evolution of the lesions. Radiographic stabilization of the lesions occurred in nine of 13 cases. We reviewed environmental conditions and optimized them to minimize stress that could predispose these rehabilitated sea turtles to opportunistic infections. Handling techniques used to move sea turtles were also improved. While we can make no conclusion regarding the cause of polyarthritis in this population of sea turtles, we successfully managed this poorly described problem in a rehabilitation setting.

In vitro susceptibility of Propionibacterium acnes to simulated intrawound vancomycin concentrations

Background

There is convincing evidence supporting the prophylactic use of intrawound vancomycin powder in spinal fusion surgery and mounting evidence in the arthroplasty literature suggesting that it can reduce surgical site infections. As a result, a number of shoulder arthroplasty surgeons have adopted this practice, despite a paucity of evidence and the presence of a pathogen that is, for the most part, unique to this area of the body—Propionibacterium acnes. The purpose of this study was to evaluate the efficacy of vancomycin against planktonic P. acnes in vitro, using time-dependent concentrations one would expect in vivo after intra-articular application.

Methods

Intrawound vancomycin concentrations were interpolated and extrapolated from existing in vivo data. Planktonic P. acnes was then subjected to a time-kill analysis during 96 hours. At each time point, the inoculum was centrifuged into pellet form and then reconstituted for serial drop counts onto blood agar plates. After anaerobic incubation, colony-forming units were counted, and log₁₀ colony-forming units per milliliter were determined.

Results

Early time points grew to confluence, and thus colony-forming units per milliliter were not calculated. However, at 12 hours of vancomycin treatment, distinct colonies were appreciated. Notably, there was a 3 × log₁₀ reduction in colony-forming units per milliliter between 12 and 48 hours, denoting bactericidal activity. In addition, P. acnes was completely eradicated after 3 days of treatment.

Conclusion

When administered in a fashion meant to simulate time-dependent in vivo intrawound concentrations, vancomycin exhibited bactericidal activity against P. acnes. This may lend credence to the prophylactic use of vancomycin in shoulder surgery.

Surgical Management of Septic Arthritis

Lameness related to synovial infection needs to be addressed promptly because rapid degradation of the synovial homeostasis results in permanent cartilage alterations detrimental to complete recovery. Diagnosis is based on clinical signs, synovial fluid analysis, and imaging. Commonly affected joints are the fetlock, carpus, tarsus, and stifle; shoulder, elbow, and hip may also be infected. Knowing the source of infection is essential in cases of remote septic arthritis. Antimicrobials should be administered; local delivery systems may be used. Therapy relies on the removal of inflammatory mediators. Pain management is critical throughout the surgical procedures and the recovery period.