title: Improved outcomes of patients with end-stage cystic fibrosis requiring invasive mechanical ventilation for acute respiratory failure.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Advanced Lung Disease and Lung Transplant Programs, C424 University of Kentucky Medical Center, 800 Rose Street, Lexington, KY 40536, USA. don.hayes@uky.edu
authors.forename: Don
authors.initials: D
authors.lastname: Hayes
authors.forename: Heidi M
authors.initials: HM
authors.lastname: Mansour
mesh_terms: D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003550:Cystic Fibrosis / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000628:therapy; D012121:Respiration, Artificial / Q000379:methods*; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014031:Tobramycin / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult; D047090:beta-Lactams / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D014031:Tobramycin