Pharmacokinetics of a single dose
of enrofloxacin administered orally to captive
Asian elephants {Elephas maximus)
Carlos R. Sanchez, DVM; Suzan Z. Murray, DVM; Ramiro Isaza, DVM, MS; Mark G. Papich, DVM, MS
Objective•
To
determine the pharmacokinetics of
enrofloxacin after oral administration to captive elephants.
Animals•
6
clinically normal adult Asian elephants
{Elephas maximus).
Procedure•
Each elephant received a single dose of
enrofloxacin (2.5 mg/kg, PO). Three elephants
received their complete diet (pellets and grain) within
2 hours after enrofloxacin administration, whereas
the other 3 elephants received only hay within 6
hours after enrofloxacin administration. Serum concentrations of enrofloxacin and ciprofloxacin were
measured by use of high-performance liquid
chromatography.
Results•
Harmonic mean half-life after oral administration was 18.4 hours for all elephants. Mean ± SD peak
serum concentration of enrofloxacin was 1.31 ±
0.40 ng/mL at 5.0 ± 4.2 hours after administration. Mean
area under the curve was 20.72 + 4.25 (ng X h)/mL.
Conclusions and Clinical Relevance•
Oral administration of enrofloxacin to Asian elephants has a prolonged elimination half-life, compared with the elimination half-life for adult horses. In addition, potentially
therapeutic concentrations in elephants were
obtained when enrofloxacin was administered orally at
a dosage of 2.5 mg/kg. Analysis of these resufts suggests that enrofloxacin administered with feed in the
manner described in this study could be a potentially
useful antimicrobial for use in treatment of captive
Asian elephants with infections attributable to organisms, such as Bordetella spp, Escherlchia coli,
Mycoplasma spp, Pasteurella spp, Haemophilus spp.
Salmonella spp, and Staphylococcus spp. (Am J Vet
ñes 2005;66:1948-1953)
acterial infections in captive elephants are common.' Some infections attributable to gram-negative bacilli, such as Escherichia coli, Enterobactcr spp,
Kkbsiella spp, Proteus spp, and Pseudomonas spp, are of
medical importance in captive elephants. Furthermore,
infections caused by SalmoneUa spp can be fatal in
captive elephants.' To effectively treat elephants with
bacterial infections, it is important to determine appropriate dosages for specific antimicrobial agents. In ele-
B
phants, antimicrobial dosages have routinely been
extrapolated from those used in equine medicine or
estimated from allometric formulas." ' Allometric studies^' of enrofloxacin have been performed, but elephants were not included in the analyses. Therefore,
pharmacokinetic studies specific for elephants are
needed to determine accurate dosages."
Of the reports from pharmacokinetic studies of
antimicrobials in elephants, most' ' ''' describe parenteral
administration of the drugs. Although IM injections are
widely used, long-term treatment by IM injection may
result in formation of sterile abscesses, pain, muscle
necrosis and inflammation, and problems with cooperation of the patients."
In the 2 pharmacokinetic studies" '" in captive elephants that included the use of orally administered
antimicrobials, investigators concluded that trimethoprim-sulfamethoxazole and ampicillin should be
administered at least twice daily to achieve effective
plasma concentrations. For practical purposes, administration of antimicrobials to captive elephants would
be better accepted if it could be accomplished once
daily because most zoologie exhibitions only have personnel available for 8- to 10-hour schedules, which
makes it impractical to achieve a 12-hour dosing interval. In addition, elephants tend to refuse orally administered drugs; therefore, the possibility of increasing
the medication interval from 12 hours to 24 hours is an
attractive alternative for zookeepers and veterinarians.
Enrofloxacin, the first ñuoroquinolone licensed
for veterinary use, has bactericidal actions through
inhibition of bacterial DNA rephcation and transcription.'"" Its activity is a concentration-dependent event,
making it ideal for once-daily administration.
Enrofloxacin has activity against some gram-positive
aerobes and a wide range of gram-negative bacilli,
including Klebsiella spp, Pseudomonas spp, and
SalmoneUa spp, and other organisms, such as
Mycoplasma spp, Staphylococcus spp, and Chlamydia
spp. '"'' Consequently this antimicrobial is clinically
useful for treatment of animals with respirator}' tract
infections, urinary tract infections, and infections
resulting from soft tissue injuries.'" '"
Received Sepiember 10, 2004.
Accepied February 24, 2005.
From the Dcpartmenl of Animal Heahh, Smithsonian National Zoological Park, 3001 Connecticut Ave N\\; Washington, DC 20008-2598
(Sanchez, Murray); Department ol Small Animal Clinical Sciences, College of Veterinary Medicine, University ol Florida, Gainesville, FL
32610 (Isaza); and Department of Molecular Biomédical Sciences, College of Veterinary Medicine, North Carolina State University Raleigh,
NC 27606 (Papich).
Supported in part by Friends of National Zoo and Bayer Corporation.
The authors thank Tony Barthel, Marie Gallowa>; Sean Royals, Deborah Flynn, Deborah Flinkman, Harr>' Locker, and Cat Monger for assistance with
sample collection; Delta Dise for assistance with the high-performance liquid chromatography analysis; and Patti Young for technical assistance.
Address correspondence to Dr. Sanchez.
1948
AJVR, Vol 66, No. 11, November 2005
Enrofloxacin is approved for use in cats, dogs,
poultry, and cattle.'"''' It has been used in an extralabel
manner in a number of species, including nondomestic
species."'''""' The use of enrofloxacin in elephants has
been limited because dosing guidelines have not been
established. Other factors that have discouraged its use
in elephants are the cost of the treatment and the large
volume of solution required when medications are
administered parenterally. Oral administration of
enrofloxacin has been used to treat elephants that have
bacterial infections without causing adverse effects,
which has encouraged additional studies"'' to define
the plasma concentrations and an accurate dosage regimen. Enrofloxacin is absorbed well in ruminants and
horses after oral or intragastric adminstration,'^' • but
to our knowledge, specific data on elephants have not
been reported. In livestock with a gastrointestinal tract
that contains fermenting bacteria, adverse effects, such
as changes in fecal consistency attributable to disruption of microorganisms in the gastrointestinal tract,
have not resulted from oral administration of
enrofloxacin.-''"* This may be attributable to the poor
activity of enrofloxacin against most anaerobic bacteria
and many gram-positive microorganisms.'^""' This
observation also provides advantages for oral administration of enrofloxacin to elephants.
Studies''"'"'" on oral administration of enrofloxacin
to horses indicate that a solution made from the
injectable product formulated for use in cattle may yield
variable results depending on the feeding status of the
horse and method of administration of the solution (gastric intubation vs oral administration). Oral administration of the injectable product formulated for use in cattle
may also have clinical effects in horses, such as the development of oral lesions.^' Because medications in zoologie settings are often hidden or mixed wdth food and we
did not want to risk development of oral lesions from this
formulation, our goal was to examine absorption of
enrofloxacin tablets when mixed wdth feed by use of 2
methods. The objective of the study reported here was to
evaluate the pharmacokinetics after oral administration
of enrofloxacin to Asian elephants (Elephas maximus)
and provide data needed to generate dosing regimens.
Materials and Methods
Animals•
Three adult female Asian elephants (range of
estimated ages, 29 to 56 years) housed at the Smithsonian
National Zoological Park (SNZP) and 3 adult female Asian
elephants (range of estimated ages, 53 to 58 years) housed at
the Ringling Brothers and Barnum Bailey Center for
Elephant Conservation (RBB) in Florida were used in the
study. Body weight of the elephants ranged from 2,988 to
4,386 kg.
One week before onset of the study, all elephants
received a routine physical examination. Laboratory' testing
was conducted, including a CBC count and serum biochemical analysis. One elephant at the RBB had chronic paralysis
of the trunk; however, on the basis of results of the physical
examination and laboratory tests, this elephant was considered otherwise healthy. The study design was reviewed and
approved by the SNZP Institutional Animal Care and Use
Committee and was in compliance with their guidehnes.
Experimental design and collection of samples•
Elephants were fed their typical diet on the day preceding
AJVR, Vol 66, No, 11, November 2005
onset of the experiment. On the day the study commenced
(day 1), the morning meal was withheld pending collection
of samples. A 10-mL blood sample was collected by use of a
12-mL syringe from an auricular vein of each elephant for
use in assay calibration and determination of baseline values
(time 0). Then, enrofloxacin' (approx 2.5 mg/kg) was given
orally in the morning. This enrofloxacin dosage was selected on the basis of a dose of enrofloxacin used in a sick elephant at the SNZP from which we were able to obtain serum
and determine that it had adequate serum concentrations
and on the basis of the empirical dosage reported elsewhere."' The dose was calculated to the nearest one-half
tablet (each tablet contained 68 mg of enrofloxacin). Tablets
were mixed with gruel (pellets, rolled oats, and rice bran
mixed with water) and provided to the 3 elephants at the
SNZP, whereas tablets were mixed with rolled oats, bran, and
molasses to form balls, which were provided to the 3 elephants at the RBB.
Each elephant completely ingested the medicine-containing gruel or balls. Elephants at the SNZP received their
typical morning diet, which consisted of hay, pellets, rice
bran, wheat bran, and rolled oats, within 2 hours after
enrofloxacin administration, whereas elephants at the RBB
received hay immediately after enrofloxacin administration
but did not receive the remainder of their typical morning
feeding until 6 hours after enrofloxacin administration.
Subsequent blood samples were collected by venipuncture of auricular veins on both ears of each elephant.
Subsequent samples were collected 30, 45, 60, and 90 minutes and 2, 2.5, 3, 4 (3 elephants at the RBB) or 5 (3 elephants at the NZP), 8, 12, 24, and 36 hours after
enrofloxacin administration. Because of difficulties in obtaining a blood sample, the samples for the 3 elephants at the
SNZP were obtained at 5 hours after enrofloxacin administration and not at 4 hours after administration.
All blood samples were placed in clot-separator tubes
and allowed to clot for approximately 2 hours at 22" to 24"C.
Tubes were then centrifuged at 1,000 to 1,300 X g for 10 minutes. Serum was harvested and stored at -70"C until assayed.
Analysis of samples•
Serum enrofloxacin concentrations were determined by use of high-performance liquid
chromatography (HPLC); ciprofloxacin concentrations were
also determined by use of the same methods. Antimicrobialfree serum from untreated elephants was pooled and fortified
with known amounts of enrofloxacin and ciprofloxacin to
validate the methods. Serum samples (unknown samples and
fortified samples) were assayed concurrently to determine
enrofloxacin and ciprofloxacin concentrations by use of a
validated method of reverse-phase HPLC and UV detection
described elsewhere.'"
The HPLC system consisted of a pump,'' an automated
sampling system,' and a UV light detector.** A 4.6-mm X
I5-cm reverse-phase column' was used to separate the
compounds of interest from other serum components. The
eluate was monitored by use of the UV detector at a wavelength of 279 nm. Enrofloxacin and ciproflo.xacin were
extracted from the serum by use of solid-phase extraction
cartridges.' The cartridges were conditioned with 1.0 mL of
methanol followed by 1.0 mL of deionized water, and then
each sample was washed with a mixture of deionized
water:methanol (95:5). Each drug was eluted from the cartridge with 1.0 mL of methanol, which was evaporated under
a flow of nitrogen gas at 45"C for 25 minutes. The dried product was reconstituted with 200 ¡iL of a mixture of
methanol:0.1% trifluoroacetic acid in water (15:85). The isocratic mobile phase was 77% deionized water, 23% acetonitrile, and 0.1% trifluoroacetic acid, and flow rate was 1
mL/min. Retention lime for enrofloxacin and ciprofloxacin
was approximately 4.0 and 3.0 minutes, respectively.
1949
Pharmacokinetic analysis•
The
pharmacokinetic
analysis was performed separately for each elephant by use of
a standard 2-stage analysis. Pharmacokinetic values for each
elephant were determined by use of noncompartmenial pharmacokinetic analysis performed with a computerized pharmacokinetic program.' Equations for calculating pharmacokinetic variables were obtained from a textbook.' Variables
for serum enrofloxacin included the area under the curve
(AUC) determined by use of the logarithmic-linear trapezoidal method, peak concentration (C•
),•
elimination halflife (ti/2), apparent volume of distribution at steady state corrected for bioavailability, and clearance corrected for
bioavailability. The equation for t|/2 was as follows; t|/2 =
Natural logarithm of 0.5/terminal rate constant. The AUC
from zero to infinity was calculated by determining the AUC
up to the last time point and then adding the terminal portion estimated from the terminal rate constant. Absolute systemic absorption could not be determined because there
were no accompanying data for IV administration.
After oral adiuinistration of enrofloxacin, C,•
.,^
ranged froin 0.82 to 1.98 jig/mL (mean ± SD, 1.31 ±
0.40 Hg/mL). Time until Cmax (t^^J ranged from 1 to
12 hours (mean, 5.0 ± 4.2 hours). Seruin enrofloxacin
concentrations in the elephants were > 0.75 jig/mL at
approximately 1 hour after oral administration. Serum
drug concentrations steadily decreased, with a harmonic mean t,/, of 18.4 hours for all elephants (arithmetic iTiean t,^,'20.42 ± 7.42 hours). The AUC ranged
from 15.58 to 26.89 (h X |ig)/mL (mean, 20.72 ±
4.25 [h X |ig]/mL). Enrofloxacin concentrations were
above the minimum inhibitory concentration (MIC)
for common pathogens in domestic animals."''"""
These pathogens include BoidcteUa spp, E coli,
Mycoplasma spp, Pasteuiella spp, Haemophilus spp.
Salmonella spp, and Staphylococcus spp, which are of
clinical importance in elephants.
Ciprofloxacin concentrations were detectable but
low and variable. Mean ± SD ciprofloxacin C•
,.,^ was
only 0.1 ± 0.06 ^g/mL at 5 hours after enrofloxacin
1.5-
T
3
E
i
O) 10-
_3.
0
u
c
0
0
^\
/
tration
Chromatograms were integraied b\- use of computer
software.' Calibration curves of peak height versus concentration were calculated by use of linear-regression analysis.
New calibration graphs for the range of 0.05 to 5.0 Mg^mL for
enrofloxacin and 0.05 to 2.0 |ig/mL for ciprofloxacin were
generated for assa>s performed each day for pooled elephant
serum obtained prior to drug administration and subsequently fortified with drug. Analytic reference standards for
enrofloxacin'' and ciprofloxacin^ were used to make the calibration standards and to fortify quality-control samples.
Between-da>- accuracy and precision were measured for
enrofloxacin and ciprofloxacin. The precision of the assay
was within ± 15% of the mean, accuracy was within ± 1D%
of the true value, and both were within published guidelines
for use in validation studies." The limit of quantification was
determined from the signal-to-noise ratio (6:1) for analysis of
unfortified serum samples and was 0.05 Hg/mL for
enrofloxacin and ciprofloxacin.
0.5-
^^
•
\•
1
^"^^--^
»5*
0
®
6
Results
Mean ± SD values for enrofloxacin and ciprofloxacin
on the serum concentration-versus-time curve for all elephants after oral administration of enrofloxacin were
plotted (Figure 1). Pharmacokinetic variables for
enrofloxacin and ciprofloxacin were calculated (Table 1).
-r
^
12
18
24
30
36
Time (h)
Figure 1•
Mean
± SD serum concentrations of enrofloxacin
(black circles) and ciprofloxacin (white circles) after oral administration of enrofloxacin at a dosage of approximately 2.5 mg/kg to
6 captive Asian elephants. Time 0 = Time of administration of
enrofloxacin.
Table 1•
Calculated pharmacokinetic variables for enrofloxacin after oral administration of a single dose
(2.5 mg/kg) to 6 captive Asian elephants.
Range
Variable
RBB(n = 3)
SNZP (3)
Mean ± SD (6)
Elimination rate (/h)
2(h)
t•
C,•
a.(Mg/mL)
AUCo,•
,.•
,i•
p•
in,([hXmgl/mL)
0.022-0.49
14.05-31.44
0.82-1.24
4.0-12.0
15.58-22.03
0.032-0.054
12.88-21.58
1.39-1.98
1.0-2.6
17.15-26.89
0.038 ± 0.013
18.4*
1.31 ±0.40
5.0 ± 4.2
20.72 ± 4.25
AUC(,,•
,i•
,•i^([hXmgl/mL)
VO/F (mUkg)
CUF (mL/h/kg)
AUMC(hX[{hXng}/mL])
MRT(h)
30.14-48.95
1,681-2,726
51.1-83.0
710-1,969
23.6-47,7
19.82-38.74
1,886-2,340
64,0-125.9
334-1,161
16.9-30.0
34.93
2,096
77.5
1,141
30.3
UJh)
± 10.20
± 375
± 26.7
± 675
±11.3
*TheSD was not calculated for this variable.
.
RBB = Ringling Brothers and Barnum Bailey Center for Elephant Conservation. SNZP = Snnithsonian
National Zoological Park. 1^2 = Elimination half-life. C^,, = Maximum serum concentration. t,•
• = Time until
C
AUC•
,• .,,i•
• , ¡•
,•• = Area under the serum concentration-versus-time curve (AUC) from time 0 to the last
"Oto last time point "
time point: ÄÜCo• ',;•
,•¡^ = AUC for the entire curve extrapolated to Infinity. VD/F = Apparent volume of distribution at steady state corrected for oral bioavailability. CL/F = Clearance corrected for bioavailability. AUMC =
Area under the moment curve. MRT = Mean residence time.
1950
AJVR, Vol 66, No. 11, November 2005
administration. Because of these low concentrations,
compared with concentrations for the parent drug
enrofloxacin, pharmacokinetic analysis was not performed for ciprofloxacin. However, ciprofloxacin concentrations were plotted on the serum concentrationversus-time curve (Figure 1).
Discussion
To our knowledge, the study reported here is the
first in which pharmacokinetics of enrofloxacin were
evaluated in elephants. In contrast, pharmacokinetics
of enrofloxacin have been extensively studied in horses,""*"'''
'••
which have a gastrointestinal tract that is
physiologically and anatomically similar to that of
elephants.
In the study reported here, enrofloxacin was
absorbed after oral administration, as indicated when
the C,•
^• of our study was compared with values reported in studies of other animals. Mean ± SD C,,,,,,, was
1.31 ± 0.40 H^mL for elephants, whereas the C,,,.,,, in
horses is 1.85,' 1.90,'' or 2.22 Hg/mL"' after oral administration of dosages that were 3 times as high as the
dosage used in our study Absorption in horses after
oral administration ranges from 49% to 66%.-'-'-"
Absorption after oral administration to elephants in our
study yielded a mean AUC of 20.72 ±
4.25 (h X |ig)/mL, which is higher than the AUC in
horses after administration at a dosage 3 times as
high,-'-' except in 1 study'" in which a compounded formulation was administered via stomach tube to horses
from which food was withheld. The possibility that
such high absorption was a function of the sample collection regimen or the analytic method cannot be ruled
out. Higher C,•
,^ and AUC values were observed in
horses in another study'" but those investigators used a
bioassay that is known to overestimate enrofloxacin
concentrations. Absorption after oral administration to
the elephants of the study reported here was particularly encouraging because enrofloxacin was administered
in a field setting in which the drug was mixed with feed.
Mean ± SD ,^^
t• was 5.0 ± 4.2 hours, which is considerably longer than the ^•t• reported'' '""'
'•
for horses (< 2 hours) when the drug is given orally or intragastrically However, the t,•
.,^ for the elephants of our
study was similar to that observed after administration
of enrofloxacin tablets to small domestic ruminants'"
and llamas,-' where ,.,^
t• is approximately 8.0 and 4.0
hours, respectively There was large variability
observed among all the elephants (range of t,•
.,^ 1 to 12
hours). When the elephants were separated into 2
groups on the basis of location (ie, SNZP and RBB),
those at the SNZP had a t,•
,^ with little variation
(range, 1 to 2.58 hours) that was similar to the t,•
,^
reported''-'"' for horses. Elephants at the RBB had a
considerably more prolonged t,•
.,^ with large variability
(range, 4 to 12 hours); these values are similar to the
t,•
,• reported for small ruminants'** and llamas."'
Enrofloxacin was administered as coated tablets
that were mixed with feed; the tablets were not
crushed or ground before addition to the feed. The
effect of food on absorption of enrofloxacin after oral
administration has been reported for other
species."-'-'*-'''' It is generally accepted that adminisAJVR, Vol 66, No. 11, November 2005
tration of fluoroquinolones with food may have
slowed or caused prolonged absorption without affecting the total serum concentration.'""' In our study we
observed an inverse effect in which the elephants at
the RBB, which received hay immediately after
enrofloxacin administration but did not receive their
complete morning meal (ie, pellets and grains) until a
few hours later, had a more prolonged interval until
Cn,•
v It has been suggested'' that concurrent administration of food may decrease the oral bioavailability of
some fluoroquinolones.
Other diet-related factors, such as differences in
water sources, diet composition (including mineral
load), amount of food, and feeding regimens between
the SNZP and RBB, could all have influenced absorption and, consequently the t,,,.,., obtained in our
study'"''' Because the effect of diet on absorption after
oral administration was not an objective of our investigation and we had only 3 elephants in each dosing
group, additional studies will be necessary to specifically address the influence of diet on absorption of
orally administered enrofloxacin in elephants.
Clinically the variability in t,•^,^ is of little relevance
because the efficacy of enrofloxacin is not based on time
at which C•
, ,^ is achieved or the amount of time that the
serum concentration is above MIC; rather, it is based on
AUC or the C•
,,,-to-MIC ratio."*" In humans and
domestic animals, a C,•
-to-MIC
•
ratio > 10:1 or an
AUC for the first 24 hours after oral administration-toMIC ratio > 100 to 125:1 is required for optimal antimicrobial effects and a lower incidence of resistance for
fluoroquinolones.'"•
"'"-•
"
We are not aware of studies on the optimum C,•
.,^to-MIC ratio or AUC-to-MIC ratio for evaluation of
efficacy of enrofloxacin in elephants. By use of the
C,•
.,x-to-MIC ratio criteria and on the basis of the
reported MICs for bacterial isolates obtained from
horses'"' and small animals," the dosage of 2.5 mg/kg,
PO, used in the study reported here (which yielded a
C•
,.,x of 1.31 |ig/mL) would be adequate for bacteria
with an MIC at which 90% of isolates are inhibited
(MICyo) of < 0.13 |ig/mL, such as £ coli isolates and
Salmonella (group B) isolates for which the MIC^o is
0.03 Hg/mL. Even organisms with a higher MIC, such
as Staphylococcus spp (MIC^,, 0.12 |ig/mL), are likely
to be susceptible to this dose of enrofloxacin. More
resistant bacteria, such as Pseudomonas aentginosa,
Rhodococcus equi. Streptococcus equi, and Streptococcus
zooepidcmicus, typically have MIC values > 0.15 Hg/mL
and may not respond as favorably to the dosage of
2.5 mg/kg. The National Committee for Clinical
Laboratory Standards (ie, NCCLS) breakpoint for
enroflo.xacin for susceptible bacterial isolates derived
from dogs and cats is an MIC < 0.5 Hg/mL. Bacterial
isolates derived from cattle are consiclered susceptible
when the MIC is < 0.25 Mg/mL. Breakpoints for susceptibility have not been derived for isolates derived
from other animals.''
In our study, oral administration of 2.5 mg of
enrofloxacin/kg yielded a mean ± SD AUC of 20.72 3:
4.25 (h X |Ug)/mL, which was slightly increased from
the value reported''''- for adult horses when
enrofloxacin is administered orally or intragastrically
1951
at 5 or 7.5 mg/kg. The AUC in the study reported here
has an AUC-to-MIC ratio > 100 for organisms with an
MIC•
o of < 0.16 |ig/mL. By use of the AUC-to-MIC
ratio criteria and on the basis of the same MICs for
equine isolates used to calculate the C,•
-to-MlC
.•
ratio,
the susceptible organisms with this approach are
similar.
The t,/, (18.23 hours) for elephants in our study
was almost twice the t,/, observed in adult horses when
enrofloxacin was given orally at dosages of 5 or 7.5
mg/kg-^-''• but similar to the t./j of enrofloxacin when
given orally at a dosage of 10 mg/kg to foals."'
Enrofloxacin has been scaled allometrically in mammals,^' and it is possible that the slower metabolic rate
of elephants may account for such a long t,;,Although pharmacokinetic variables were not calculated for ciprofloxacin, the values were considered low,
which is similar to an observation in foals." Other animals
(eg, pigs) also have low concentrations of ciprofloxacin
after administration of enrofloxacin.* The factors (eg, diet
or hepatic activity) that account for species differences in
metabolism of enrofloxacin to ciprofloxacin are not
known. Low concentrations of ciprofloxacin identified in
our study would contribute an additive (albeit small)
effect to the antimicrobial activity"^"""*
Oral administration of enrofloxacin in the form of
68-mg coated tablets to captive Asian elephants resulted in serum drug concentraüons as high or higher
than those attained after oral administration of higher
doses to domestic mammals, such as horses. In elephants, enrofloxacin had a long tj^j, compared with
the t,/2 for enrofloxacin in other mammals. The serum
concentrations attained when enrofloxacin is administered orally at a dosage of 2.5 mg/kg once daily are
potentially therapeutic. Analysis of results of the study
reported here suggests that oral administration of
enrofloxacin mixed with feed in the manner described
is potentially useful for treatment of captive Asian elephants with infections caused by enrofloxacin-susceptible organisms, such as Bordetella spp, E coli,
Mycoplasma spp, Pasteurella spp, Haemophilus spp.
Salmonella
spp,
and
Staphylococcus
spp.
Administrarion of enrofloxacin at the suggested
dosage in clinical trials is necessary before we can conclude that treatment is effective.
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
Baylril, 68-mg coated lablels, Bayer Corp, Shawnee Mission,
Kan.
Agilem quaternary pump, Agilent Technologies, Wilmington,
Del.
Agilent series 1100, Agilent Technologies, Wilmington, Del.
Agilent 1100 series UV detector, Agilent Technologies,
Wilmington, Del.
Zorbax SB C-8, Mac Mod, Chadds Ford, Pa.
Oasis, Waters Corp, Milford, Mass.
HP ChemStation software, series 1100 software, Agilent
Technologies, Wilmington, Del.
Enrofloxacin analytical reference standard, Bayer Corp.
Shawnee Mission, Kan.
Ciprofloxacin analytical reference standard, US Pharmacopeia,
Rockville, Md.
WinNolin, version 4.0, Pharsight Corp, Mountain View, Calif,
Pirro R, Scheer M, de Jong A. Additive in vitro activity of
enrofloxacin and its main metabolite ciprofloxacin (abstr), in
Proceedings. 14th Annu Cong Eur Soc Vet Dermatol 1997;199.
1952
References
1. Mikota SK, Sargent EL. Ranglack GS. Causes of death. In:
Mikota SK, Sargent EL. Ranglack GS, eds. Mcdiail numaganent of the etephanl. West Bloomficld, Mich: Indira Publishing House. 1994:219-224.
2. Olsen JH. Antibiotic therapy in elephants. In: Fowler ME,
Miller RE. eds. Zoc and uiW iiiiiinn) iiiaiiiinc: tiinviil \elerinwy theriip\ 4. Philadelphia: WB Saundcrs Co. 1999:533-541.
3. Schmidt MJ. Penicillin G and amoxicillin in elephants: a
study comparing dose regimens administered with serum levels
achieved in healthy elephants. J Zoo-Anim Mai 1978:9:127-136.
4. Bregante MA, Saez ?. Arama\ona JJ, et al. Comparative
pharmacokinetics of enrofloxacin in mice, rats, rabbits, sheep, and
cows. AmJ Vet Res 1999:60:1111-1116.
5. Cox SK. Cottrell MB. Smith L, et al. .-Mlomctric analysis of
ciprofloxacin and enroflo.xacin pharmacokinetics across species. J Vcl
Pharmacol Ther 2004:27:139-146.
6. Vogelman B, Gudnuindsson S, Lcggetl JE, et al. Correlation
of antimicrobial pharmacokinetics parameters with therapeutic efficacy in an animal model. J lii/ccf Di.s 1988:158:831-847.
7. Lodwick LJ, Dubach JM, Phillips LG, et al.
Pharmacokinetics of amikacin in African elephants (LOXOíIOIIííI
íi/riciiiiíi). J Zoo WiUn Mcd 1994;25:367-375.
8. Page CD, Mautino M, Derendorf HD, et al. Comparative
pharmacokinetics of trimethoprim-sulfamethoxazole administered
intravenously and orally to captive elephants. ] Zoo Wiidl Med
1991;22:409-416.
9. Bush M, Raalb JP de Vos V, et al. Serum oxyletracycline le\els in free-ranging male African elephants (Loxodoiiía africana) injected with a long-acting formulation. J Zoo Wiltil Mcii 1996;27:382-385.
10. Bush M, Stoskopf MK, Raath JP et al. Scrum oxytelracycline
concentrations in African elephants (Loxodonta africana) calves after
long-acting formulation injection. J Zoo Wildl Mcd 2000;31:41-46.
11. Isaza R, Hunter RR Drug delivery to captive Asian elephants•
treating goliath. Curr Drug Dcliv 2004;1:291-298.
12. Rosin E, Schultz-Darken N, Perry B, et al. Pharmacokinetics
of ampicillin administered orally in Asian elephants (Elephas maximus).]Zoo Wildl Mcd 1993;24:515-518.
13. Papich MG, Riviere JE. Fluoroquinolone antimicrobial
drugs. In: Adams R, ed. Veterinary pharmacology and therapeutics. 8th
ed. Ames, Iowa: Iowa State University Press, 2001;898-917.
14. Walker RD. Fluoroquinolones. In: Prescott JE ed.
Aníimicrobiíi/ therapy in vfieriiiaiy' meditiiic. 3rd ed. Ames, Iowa:
Iowa State University Press, 2000;315-338.
15. Vancutsem PM, Babish JG, Schwark WS. The fluoroquinolone antimicrobials: structure, antimicrobial activity, pharmacokinetics, clinical use in domestic animals and toxicily Comell Vet
1990;80:173-186.
16. Plumb DC. Drug monographs. In: Plumb DC, ed. Veterinary
drug handbook. 3rd ed. Ames, Iowa: Iowa State University Press,
1999:238-241.
17. McKellar QA. Clinical relevance of the pharmacologie properties of fluoroquinolones. Suppt Compend Contin Ediic Pract Vet
1996;18:14-21.
18. Stegemann M. Microbiology and pharmacology of
enrofloxacin in cattle. Bovine Pract 1997;31:76-81.
19. Enrofloxacin (package insert]. Shawnee Mission, Kan:
Bayer Corp, Agriculture Division, Animal Health, 2001.
20. Gamble KG, Boothe DM,Jensen JM, el al. Pharmacokinetics
of a single intravenous enrofloxacin dose in scimitar-horned oryx
(Oryx dammah).] Zoo Wildl Med 1997;28:36-42.
21. Gandolf AR, Papich MG, Bringardner AB, et al.
Pharmacokinetics after intravenous, subcutaneous, and oral administration of enrofloxacin in alpacas. AmJ Vet Res 2005;66:767-771.
22. Schmidt MJ. Antibiotic therapy in elephants. In: Fowler
ME, Miller RE, eds. Zoo and wild animal mcdiciiic: current vcieriiiary
therapy 4. Philadelphia: WB Saunders Co, 1999;538.
23. Houck R. Antibiotic therapy in elephants. In: Fowler ME,
Miller RE, eds. Zoo and wild animal medicine: current wlerinary therapy 4. Philadelphia: WB Saunders Co, 1999;538.
24. Langston VC, Sedrish S, Boothe DM. Disposition of singledose oral enrofloxacin in the horse. ] Vet Pharmacol Tlier
1996;19:316-319.
25. Haines GR, Brown MP, Gronwall RR, el al. Serum eoncen-
AJVR, Vol 66, No. 11, November 2005
k
traitons and pharmacoUinetics of enronoxacin after intravenous and
intragastric administration to mares. CanJ Vet Res 2000;64:171-177.
26. Giguere S, Sweeney RW, Bélanger M. Pharmacokinetics of
enrofloxacin in adult horses and concentration of the drug in serum,
body fluids, and cndometrial tissues after repeated intragastrically
administered doses. Am] Vcl Res 1996;57:1025-1030.
27. Boeckh C, Buchanan C, Boeckh A, et al. Pharmacokinetics
of the bovine formulation of enrofloxacin (Baytril' 100) in horses.
Vet T/itT 2001;2:129-134.
28. Bermingham EC, Papich MG. Pharmacokinetics after intravenous and oral administration of enrofloxacin in sheep. Am] Vet Res
2002;63:1012-1017.
29. Epstein K, Cohen N, Boolhe D, et al. Pharmacokinetics, stability, and retrospective analysis of use of an oral gel formulation of the
bovine injectable enrofloxacin in horses. Vcl Ther 2004;5:155-167.
30. Bermingham EC, Papich MG, Vivrett SL. Pharmacokinetics
of enroflo.xacin administered intravenously and orally to foals. Am ]
Vet Res 2000;61:706-709.
31. Shah VR Midha KK, Dighe S, et al. Conference report: analytical methods validation: bioavailability, bioequivalence, and pharmacokinetic studies. IntJ Pharin 1992;82:1-7.
32. Gibaldi N, Perrier D. Appendix A-H. In: Gibaldi M, Perrier D,
eds. Pfiarmacofciiicics. 2nd eel. New York: Marcel Dekker Inc,
1982;419-477.
33. Pirro F, Edingloh M, Schmeer N. Bactericidal and inhibitory activity of enrofloxacin and other fluoroquinolones in small animal pathogens. SuppI Compend Contin Educ Pract Vet 1999;21:19-25.
34. Greene CE, Budsberg SC. Veterinary use of quinolones. In:
Hoper DC, Wolfson JS, eds. Quinolone antimicrobial agents. 2nd ed.
Washington, DC: American Society for Microbiology, 1993;473-488.
35. Prescott JF, Yielding KM. In vitro susceptibility of selected
veterinary bacterial pathogens to ciprofloxacin, enrofloxacin and
nornoxacin. Can] Vet Res 1990;54:195-197.
36. Giguere S, Bélanger M. Concentration of enrofloxacin in
equine tissues after long-term oral administration. ] Vet Pharmacol
Ther 1997;20:402-404.
AJVR, Vol 66, No. 11, November 2005
37. Papich MG, Van Camp SD, Cole JA, et al. Pharmacokinetics
and endometrial tissue concentrations of enrofloxacin and the
metabolite ciprofloxacin after i.v administration of enrofloxacin to
mares. J Vet Pharmacol Ther 2002;25:343-350.
38. Küng K, Riond JL, Wanner M. Pharmacokinetics of
enrofloxacin and its metabolite ciprofloxacin after intravenous and
oral administration of enrofloxacin in dogs. J Vet Pharmacol Ther
1993;16:462-468.
39. Lode H, Borner K, Koeppe R Pharmacodynamics of fluoroquinolones. Clin Inject Dis 1998;27:33-39.
40. Drusano GL,Johnson DE, Rosen M. et al. Pharmacodynamics
of a fluoroquinolone antimicrobial agent in a ncutropenic rat model of
Pseudomonas sepsis. Antlmiciob Ageiils C/ifiiiotdcr 1993;37:483-490.
41. Forrest A, Nix DE, Ballow CH, ct al. Pharmacodynamics of
intravenous ciprofloxacin in seriously ill patients. Antimicrob Agents
Chenwther 1993;37:1073-1081.
42. Hyatt JM, McKinnon PS, Zimmer GS, et al. The importance
of pharmacokinetic/pharmacodynamic surrogate markers to outcome. Focus on antibacterial agents. Clin P/iarmíicofcinft 1995;
28:143-160.
43. Blaser J, Stone BB, Groner MC, et al. Comparative study
with enoxacin and netilmicin in a pharmacodynamic model to determine importance of ratio of antibiotic peak concentration to MIC for
bactericidal activity and emergence of resistance. Antimicrob Aj^enis
Cliemotlicr 1987;31:1054-1060.
44. EnsinkJM, van Klingeren B, Houwers DJ, et al. In-vitro susceptibility to antimicrobial drugs of bacterial isolates from horses in
The Netherlands. Equine VetJ 1993;25:309-313.
45. The National Committee for Clinical Laboratory Standards.
Performance standards for cmtimicrobicd disk and diliiiion sustcpíibi/iíy
tests for bacteria isolated from animals; approved standard. 2nd ed.
NCCLS document M31-A2. Wayne, Pa: National Committee for
Clinical Laboratory Standards, 2002.
46. Nielsen P Gyrd-Hansen N. Bioavailability of enrofloxacin
after oral administration to fed and fasted pigs. Pharmacol Toxicol
1997;80:246-250.
1953