S. Jacks et al., Pharmacokinetics of azithromycin and concentration in body fluids and bronchoalveolar cells in foals, AM J VET RE, 62(12), 2001, pp. 1870-1875
Objective-To determine the pharmacokinetics of azithromycin and its concent
ration in body fluids and bronchoalveolar lavage cells in foals.
Animals-6 healthy 6- to 10-week-old foals.
Procedure-Azithromycin (10 mg/kg of body weight) was administered to each f
oal via IV and intragastric (IG) routes in a crossover design. After the fi
rst IG dose, 4 additional IG doses were administered at 24-hour intervals.
A microbiologic assay was used to measure azithromycin concentrations in se
rum, peritoneal fluid, synovial fluid, pulmonary epithelial lining fluid (P
ELF), and bronchoalveolar (BAL) cells.
Results-Azithromycin elimination half-life was 20.3 hours, body clearance w
as 10.4 ml/min.kg, and apparent volume of distribution at steady state was
18.6 L/kg. After IG administration, time to peak serum concentration was 1.
8 hours and bioavailability was 56%. After repeated IG administration, peak
serum concentration was 0.63 +/- 0.10 mug/ml. Peritoneal and synovial flui
d concentrations were similar to serum concentrations. Bronchoalveolar cell
and PELF concentrations were 15- to 170-fold and 1- to 16-fold higher than
concurrent serum concentrations, respectively. No adverse reactions were d
etected after repeated IG administration.
Conclusions and Clinical Relevance-On the basis of pharmacokinetic values,
minimum inhibitory concentrations of Rhodococcus equi isolates, and drug co
ncentrations in PELF and bronchoalveolar cells, a single daily oral dose of
10 mg/kg may be appropriate for treatment of R equi infections in foals. P
ersistence of high azithromycin concentrations in PELF and bronchoalveolar
cells 48 hours after discontinuation of administration suggests that after
5 daily doses, oral administration at 48-hour intervals may be adequate.