Bring a large pot of salted water to boil and cook pasta according to package directions. Reserve 1 cup (250 mL) pasta water. Drain well and set aside.
Meanwhile, heat a large skillet over medium heat and cook bacon until golden brown and starting to crisp. Remove bacon from pan with a slotted spoon, transferring to a paper towel lined plate. Keep warm and set aside.
Remove all but 4 tbsp. of rendered bacon fat from pan. Add garlic to pan and cook 1 to 2 min., stir in pesto and cream cheese, and whisk to combine. Add pasta to the pan and stir in bacon, cherry tomatoes and parmesan. If sauce is too thick, add some reserved pasta water. Garnish with basil and extra parmesan.
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