Improved outcomes of patients with end-stage cystic fibrosis requiring invasive mechanical ventilation for acute respiratory failure

Study Objectives The aim of this study was to determine the effects of an antibiotic strategy with intravenous (IV) continuous infusion of a β-lactam (CIBL) antibiotic and high-dose extended-interval (HDEI) tobramycin upon outcomes in patients with cystic fibrosis (CF) requiring invasive mechanical ventilation (IMV) for acute respiratory failure. Design The study was a retrospective review from June 1, 2006, to December 1, 2010, of patients at a university hospital with an adult CF center. Results The study population included adult CF patients requiring IMV. A total of 15 hospitalizations with IMV episodes were reviewed, involving 10 adult (31.4±11.1 years) CF patients with end-stage lung disease (FEV ₁ = 23.6±7.8% predicted) and malnutrition (body mass index = 20.5±3.1). Each patient survived to discharge and to follow-up 6 months later without the need for lung transplantation during the study period. Conclusions A novel antibiotic strategy with a CIBL antibiotic and HDEI tobramycin improved survival in a small cohort of critically ill CF patients with end-stage lung disease and malnutrition requiring IMV.