1468. Cidofovir Prescribing Patterns and Outcomes in Hospitalized Adults and Children

Abstract Background Cidofovir (CDV) dosing is based on limited clinical evidence and varies by indication. The optimal dose to achieve a virologic response has not been established. Routine lab monitoring, renal adjustments, co-administration with intravenous (IV) fluids probenecid are recommended limit CDV-associated nephrotoxicity but lack standard approach. Methods This was retrospective evaluation of patients admitted Atrium Health’s Carolinas Medical Center or Levine Children’s Hospital who received at least one CDV from August 1, 2014 through June 30, 2021. primary objective describe prescribing patterns. Secondary objectives included evaluating response, nephrotoxicity, IV fluid use. Results A total 38 adult 26 pediatric were 44 60 doses, respectively. Adult variable, the most common regimens for BK virus infections 0.5 mg/kg every other week solid organ transplant recipients (Figure 1A-B) 1 weekly stem cell 1C). Dosing adenovirus inconsistent 1D). All evaluated had decrease in viral load during first two weeks 2A-D). In patients, three times which used 67% across all indications 1E-I). Three an increase 2E-H), no similarities indication noted. rate pre-defined increases serum creatinine 29% adults 14% patients. Use boluses both (Table 1). Of that did receive probenecid, only 16.7% > mg/kg. Conclusion Evaluation small sample size. However, high variability patterns highlights need standardized, indication-specific dosing. Standardization use along guidance adjustments insufficiency may help risk nephrotoxicity. Disclosures Authors: No reported disclosures.