Reconsider Amikacin at Reduced Doses for Joint Injections

Study: Amikacin is indeed toxic to cartilage, synovial cells, and stem cells. When used preventively for joint injections, lower doses are likely warranted.

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Reconsider Amikacin at Reduced Doses for Joint Injections
When used preventively for joint injections, lower doses of Amikacin are likely warranted. | Photo: The Horse Staff
Performing joint injections, albeit routine in many sectors of the equine industry, is not without risk. Joint flares or infections can develop that, if not diagnosed and treated promptly, can result in loss of use or life.

To help minimize the development of post-injection infections, almost 50% of equine veterinarians report combining an antimicrobial agent such as amikacin with any medication injected into a joint. Such intra-articular products include polysulfated glycosaminoglycans (PSGAGs), hyaluronic acid, and even corticosteroids.

“Despite being popular, the inclusion of antibiotics in joint injections has not been shown to reduce the risk of infection following injection,” said PhD student Lynn Pezzanite, DVM, MS, Dipl. ACVS (Large Animal), of Colorado State University. “Amikacin is known to be toxic to several mammalian cell types, and the effect of this antibiotic on cells within the joint has not specifically been examined.”

Further, using antibiotics in joints is “off-label” according to drug guidelines, and no data  currently support the doses of antibiotics equine veterinarians use in joints

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Written by:

Stacey Oke, MSc, DVM, is a practicing veterinarian and freelance medical writer and editor. She is interested in both large and small animals, as well as complementary and alternative medicine. Since 2005, she’s worked as a research consultant for nutritional supplement companies, assisted physicians and veterinarians in publishing research articles and textbooks, and written for a number of educational magazines and websites.

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