Does once-daily dosing of aminoglycosides affect neuromuscular function?

Area of Science:

• Critical Care Medicine
• Pharmacology
• Respiratory Physiology

Background:

• Aminoglycosides can cause neuromuscular blockade at high serum concentrations.
• Concerns exist regarding increased risk with once-daily aminoglycoside dosing due to higher peak serum levels.
• Neuromuscular blockade from aminoglycosides is rare in humans with traditional dosing.

Purpose of the Study:

• To investigate if once-daily aminoglycoside dosing affects respiratory muscle function.
• To assess the potential for increased neuromuscular blockade with new dosing regimens.

Main Methods:

• Nine mechanically ventilated ICU patients received once-daily gentamicin (6 mg/kg/day).
• Respiratory muscle strength was measured using maximum inspiratory pressure (MIP).
• MIP was recorded before (MIPpre) and after (MIPpost) gentamicin administration.

Main Results:

• Mean MIPpre was -26.7 cm H2O and mean MIPpost was -26.5 cm H2O.
• The difference between MIPpre and MIPpost was -0.2 cm H2O.
• This difference was not statistically significant (P > 0.05).

Conclusions:

• Once-daily gentamicin at 6 mg/kg/day did not significantly impact respiratory muscle function.
• Measurement of MIP suggests that once-daily aminoglycoside dosing does not inhibit weaning from mechanical ventilation.
• The observed effects on respiratory muscle function were neither statistically nor clinically significant.