Levofloxacin may reduce risk of developing multidrug-resistant tuberculosis in both children and adults
France: Findings from two phase 3 trials revealed that levofloxacin is safe and lowered the risk of multidrug-resistant (MDR) tuberculosis (60% reduction) among children, adolescents and adults by 60%. The findings were presented at the Union World Conference on Lung Health in Paris.
"An oral antibiotic, levofloxacin, taken once daily for six months can substantially reduce the risk of developing multidrug-resistant tuberculosis (TB) in both children and adults," UCL researchers reported.
The studies were conducted separately among children in South Africa and adolescents and adults in Vietnam. The findings confirmed the efficacy and safety of levofloxacin and identified a method for preventing MDR-TB spread among family and household members.
In 2022, there were 7.5 million people globally diagnosed with tuberculosis in 2022, the highest number of cases since 1995, according to WHO, which noted that the increase can at least be partially attributable to public health system improvements in many nations.
According to WHO, there were above 410,000 cases of MDR-TB or rifampin-resistant TB reported worldwide in 2022, with roughly two in five patients receiving treatment. Of these, about 115,000 infections occurred in children, with fewer than four in five able to receive treatment.
One trial, known as TB-CHAMP was conducted in South Africa at five research sites in six provinces serving communities with high burdens of TB and MDR-TB. It was led by the MRC Clinical Trials Unit (CTU) at UCL, and Stellenbosch University was responsible for the trial management and statistical analysis.
The study included 922 adolescents and children exposed to an adult with MDR-TB in their household. They found that Levofloxacin reduced the risk of MDR-TB disease by 56%. After one year, 1.1% of children who were given levofloxacin had developed TB, compared to 2.6% who were given a placebo.
Levofloxacin was safe for children, with very few side effects reported. Tendonitis and joint pain and, traditionally a concern with levofloxacin use, were very uncommon among participants.
Another study, the VQUIN trial, led by the University of Sydney and the Woolcock Institute of Medical Research, was conducted across ten provinces in Vietnam and focused primarily on adults. The study included 2,041 adults and children living with a person with MDR-TB in the household and found that levofloxacin reduced the risk of MDR-TB by 45%.
In further analyses led by UCL researchers, the data from both trials were combined, confirming that levofloxacin was similarly effective in TB prevention in adults and children and was safe.
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