2026-10-09T18:10:00Z https://api.figshare.com/v2/oai

oai:figshare.com:article/32640240 2026-10-01T16:32:59Z portal_1172 item_type_8 month_year_10_2026

Levofloxacin: reducing the risk of Pseudomonas aeruginosa resistance Callum Matthew Sloan (24169140) PUREID: 614446893 Levofloxacin Pseudomonas aeruginosa cystic fibrosis antimicrobial resistance inhaled antibiotics respiratory pathogens in vitro evolution whole genome sequencing antimicrobial prescribing <i>Pseudomonas aeruginosa</i> (<i>P. aeruginosa</i>) is a common cause of airway infections in people with cystic fibrosis (pwCF). Nebulised levofloxacin is the latest inhaled antibiotic available to manage chronic <i>P. aeruginosa</i> infections in pwCF. Little data is currently available on how this therapy is practically used in CF clinics or how <i>P. aeruginosa</i> isolates respond to levofloxacin exposure and the impact of antibiotic rotation during the administration of long-term inhaled antibiotic regimens. This thesis aimed to (i) determine how inhaled antibiotics are currently used in CF centres across Europe and the place of nebulised levofloxacin in the treatment of chronic <i>P. aeruginosa</i> infections, (ii) the impact of <i>in vitro</i> levofloxacin exposure and subsequent antibiotic rotation on levofloxacin resistance development in clinical <i>P. aeruginosa</i> isolates from pwCF, and (iii) the underlying genomic mechanisms contributing to levofloxacin resistance. The results of this thesis aim to provide an insight into the current use of nebulised levofloxacin in the clinic as well as a better understanding of the development of <i>in vitro</i> levofloxacin resistance in <i>P. aeruginosa</i> and the genetic mechanisms contributing to this. These results could inform the design of future inhaled antibiotic regimens to reduce the risk of resistance development in <i>P. aeruginosa</i> and ensure continued efficacy for current and future pwCF.<br><br><i>Thesis is embargoed until 31st December 2027</i>.<br><br><br> 2026-10-01T16:32:59Z Text Thesis 10.17034/32640240.v1 https://figshare.com/articles/thesis/Levofloxacin_reducing_the_risk_of_Pseudomonas_aeruginosa_resistance/32640240 All Rights Reserved Open Access after 2027-12-31