New eFlows produce larger droplets and in a narrower size range compared to new LC Plus nebulizers for TOBI, and therefore both devices are not equivalent. Theoretically a larger portion of the aerosol from eFlow is likely to be deposited in the upper airways. The performance of both tested nebulizers decreases after 6 months of use. For the eFlow, timely replacement of the mesh is necessary. These in vitro results underscore the importance of registration studies of new drug-device combinations.
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