Osteopathic Lymphatic Pump Treatment Does Not Alter Antibiotic Distribution in a Rat Model

Purpose: Osteopathic doctors perform manual medicine treatments to promote the body to self-heal. The lymphatic pump technique (LPT) is one of these treatments and it has been shown to improve lymph circulation and delivery of immune factors. In 2010 we developed a rat model to study the effect of LPT on the lymphatic system. We found that 4 minutes of LPT significantly increased the lymph flow and the concentration of lymphocytes in the lymph. We also found that the combination of LPT and levofloxacin protected against Streptococcus pneumoniae-mediated pneumonia by reducing the concentration of bacteria in the lungs. Furthermore, LPT has been shown to increase the uptake of antigen from the interstitium; therefore, LPT may act as an adjunctive therapy during the treatment of pneumonia by enhancing the uptake and delivery of antibiotics. Specifically, we hypothesized that LPT would increase the concentration of levofloxacin in the lungs. Materials and Methods: Male, Fisher 344 rats with jugular vein catheters weighing between 200-300 grams were used. Rats were injected subcutaneously with 50 mg/kg levofloxacin and randomized into control, sham, or LPT groups. Control rats received no treatment or anesthesia, sham rats received anesthesia for 4 minutes, and LPT rats received LPT under anesthesia for 4 minutes. Ten minutes post-treatment, serum and bronchoalveolar lavage fluid (BALF) were collected and the concentration of levofloxacin was determined using a levofloxacin bioassay. Results: In serum, there was no significant difference (p value= 0.74) in the levofloxacin concentration between control (3.8±0.4 μg/ml), sham (3.9±0.6 μg/ml), or LPT (4.3±0.5 μg/ml). Similarly in the BALF, there was no significant difference (p value= 0.69) in the levofloxacin concentration between control (0.14±0.03 μg/ml), sham (0.10±0.03 μg/ml), LPT (0.12 ±0.03 μg/ml). Conclusion: In conclusion, the results from this experiment suggest that LPT does not enhance the delivery of levofloxacin to the lungs. Alternatively, LPT may act as an adjunctive therapy during the treatment of pneumonia by enhancing immune-mediated protection. Future studies are necessary to test this hypothesis.