Exploring the Use of Levofloxacin as a Prophylaxis to Prevent Household Transmission of Multidrug Resistant Tuberculosis in Vietnam
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on January 20th, 2025
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The emergence of multidrug-resistant (MDR) bacteria has reversed the progress made in controlling infectious diseases, making them a significant public health threat once again, with tuberculosis being one of the key concerns. Patients infected with MDR tuberculosis have lower treatment success rates and experience more severe disease compared to those with susceptible strains. Levofloxacin is one of the antibiotics used to treat MDR tuberculosis, and the National Health and Medical Research Council of Australia has funded a study to investigate the use of levofloxacin as a prophylactic measure to prevent the spread of MDR tuberculosis among individuals living with infected patients.
The clinical trial was conducted across 10 urban and rural provinces in Vietnam and included 2,041 individuals who had household contact with individuals diagnosed with MDR tuberculosis or rifampicin-resistant tuberculosis. None of the participants showed signs of tuberculosis disease, but 89.5% tested positive on the tuberculin skin test. Participants were randomly assigned to receive either a placebo or levofloxacin at a daily dose of 10 to 15 mg per kilogram of body weight for adults, and 20 mg for children. After 180 days of prophylactic treatment, the researchers found that levofloxacin reduced the risk of developing tuberculosis in household contacts by a small, but statistically insignificant, amount. Analysis of adverse events revealed that levofloxacin significantly increased the risk of adverse effects, with a treatment discontinuation rate of 7%, although most reported events were mild. Additionally, the researchers discovered that around half of the household contacts who later developed tuberculosis contracted the disease from sources outside their household, suggesting that adding other antibiotics, such as rifampin and isoniazid, to the prophylaxis regimen could potentially further reduce the risk of transmission
The clinical trial was conducted across 10 urban and rural provinces in Vietnam and included 2,041 individuals who had household contact with individuals diagnosed with MDR tuberculosis or rifampicin-resistant tuberculosis. None of the participants showed signs of tuberculosis disease, but 89.5% tested positive on the tuberculin skin test. Participants were randomly assigned to receive either a placebo or levofloxacin at a daily dose of 10 to 15 mg per kilogram of body weight for adults, and 20 mg for children. After 180 days of prophylactic treatment, the researchers found that levofloxacin reduced the risk of developing tuberculosis in household contacts by a small, but statistically insignificant, amount. Analysis of adverse events revealed that levofloxacin significantly increased the risk of adverse effects, with a treatment discontinuation rate of 7%, although most reported events were mild. Additionally, the researchers discovered that around half of the household contacts who later developed tuberculosis contracted the disease from sources outside their household, suggesting that adding other antibiotics, such as rifampin and isoniazid, to the prophylaxis regimen could potentially further reduce the risk of transmission