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Musculoskeletal Adverse Effects Associated with Inhaled Levofloxacin in a Patient with Cystic Fibrosis: A Case Report

Alwadaei S, Allsup N, Shiferaw D

Respiratory medicine, 2026

Abstract

Inhaled levofloxacin is widely used in cystic fibrosis (CF) patients with chronic Pseudomonas aeruginosa infection and is generally well tolerated. The most commonly reported adverse effects are bronchospasm and dysgeusia, with limited evidence of systemic toxicity. We report a case of a 26-year-old woman with CF who developed recurrent diffuse musculoskeletal pain temporally associated with inhaled levofloxacin therapy. Symptoms occurred exclusively during treatment cycles, resolved upon discontinuation, and have not recurred since cessation. This case highlights a potential association between inhaled levofloxacin and musculoskeletal adverse effects, emphasizing the need for clinician awareness despite the drug's favorable safety profile.

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