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Ceftolozane-tazobactam (TOL-TAZ) affords broad coverage against Pseudomonas aeruginosa. Regrettably, TOL-TAZ resistance has been reported. We sought to identify modifiable risk factors that may reduce the emergence of TOL-TAZ resistance. Twenty-eight patients infected with carbapenem-resistant P. aeruginosa isolates susceptible to TOL-TAZ and treated with ≥72 hours of TOL-TAZ between January 2018 and December 2019 in Baltimore, Maryland were included. The 28 patients had P. aeruginosa isolates available both before and after TOL-TAZ ex