PMC9674917_01
Pulmonary function, antibiotic requirements, and symptom scores while on inhaled/nebulized antibiotics.. Panel A: Depiction of FEV1 measures (open circles) and antibiotic requirements (solid horizontal lines) pre- and post-introduction of inhaled levofloxacin (dashed vertical line). CFQ-R respiratory scores are represented by red-filled diamonds. Panel B: Following introduction of levofloxacin, FEV1 was higher during periods of levofloxacin use than tobramycin use (2.29 L vs 2.22 L, mean difference 70 mL [95%CI: 16-124 mL, p = 0.0074] by two-tailed Welch's t-test). Panel C: FEV1 values remained significantly higher when comparing levofloxacin measurements to TIP (p = 0.0176) and not significantly higher than those taken during TIS use (p = 0.493) (by post-hoc Dunn test with p-value adjustment by Benjamini-Hochberg method). CFQ-R = Cystic Fibrosis Questionnaire-Revised, FEV1 = forced expiratory volume in 1 second, IV-abx = intravenous antibiotics, Levo = levofloxacin, ns = not significant, PEx = pulmonary exacerbation, PO-abx = oral antibiotics, TIP = tobramycin inhalation powder, TIS = tobramycin inhalation solution. *p < 0.05, **p < 0.01.
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This translated to a decrease in antibiotic exposure from 105 antibiotic days per 9-month period pre-levofloxacin to 30 antibiotic days per 9-month period after starting alternating months of levofloxacin (Fig. 1a). Following introduction of levofloxacin, the mean FEV1 was higher while receiving levofloxacin than during tobramycin use (2.29 L vs 2.22 L, mean difference 70 mL [95%CI: 16-124 mL, p = 0.007] by two-tailed Welch's t-test) (Fig. 1b). This difference was preserved when stratifying to compare levofloxacin to TIP, and attenuated when comparing levofloxacin to TIS (Fig. 1c).