P250 Minimum inhibitory concentration targeted antibiotic dose optimization in patients with cystic fibrosis

Frequent pulmonary exacerbations of Cystic Fibrosis (CF) reduce survival and quality life even among patients receiving highly effective modulator therapy suggesting the need for better treatments. Our primary objective was to discern whether antibiotics matched with bacterial culture susceptibilities meeting minimum inhibitory concentration (MIC)-based target serum levels improve exacerbation treatment outcomes. MIC directed antibiotic dose selection optimization is standard practice at our center. A retrospective chart review conducted from 2010–2015, 2 year follow up, evaluating CF admitted a exacerbation. We used Kaplan-Meier statistics Cox proportional hazards modeling evaluate time next randomly selected adult inpatients who had pre-admission sputum cultures data prior admission. Treatment included intravenous (IV) nearly all continuous infusion β-lactam most daily IV aminoglycoside. dosed based on individual verified dosing decisions therapeutic drug monitoring (TDM). 99 met inclusion exclusion criteria. plots showed that targeting aminoglycoside area under curve (AUC) values were associated lengthened median by 80 [HR = 0.55, 95% CI (0.33–0.90)] 185 days 0.42, (0.24–0.74)] respectively. However, achieving both extended 414 0.23, (0.10–0.53)]. Highly did not change results. Dual successful TDM prolongs This strategy applies people regardless eligibility status or access.