Related Experiment Video
Updated: Jun 4, 2025
The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
Published on: August 11, 2008
Levofloxacin for the Prevention of Multidrug-Resistant Tuberculosis in Vietnam
Greg J Fox1, Nguyen Viet Nhung1, Nguyen Cam Binh1
1From the Faculty of Medicine and Health (G.J.F., P.N.Y., E.L.M., H.M.Y., E.G.-R., P.D.C., B.J.M., N.T.A.), the Sydney Infectious Diseases Institute (B.J.M.), and Sydney Medical School (H.M.Y.), University of Sydney, and Royal Prince Alfred Hospital, Sydney Local Health District (G.J.F.), Camperdown, NSW, the Woolcock Institute of Medical Research, Macquarie Park, NSW (G.J.F., N.C.B., P.N.Y., P.D.C., N.T.A., G.B.M.), the School of Clinical Medicine, University of New South Wales, Liverpool (F.L.G.), and the Department of Paediatrics, University of Melbourne (S.M.G.), and the Division of Global Health, Burnet Institute (G.B.M.), Melbourne, VIC - all in Australia; the University of Medicine and Pharmacy, Vietnam National University (N.V.N.), and the National Lung Hospital, Ba Dinh District (N.B.H., N.K.C.), Hanoi, and Pham Ngoc Thach Hospital, Ho Chi Minh City (N.H.L.) - all in Vietnam; the Departments of Medicine (A.B., O.S., M.A.B., D.M.), Epidemiology, Biostatistics, and Occupational Health (A.B., M.A.B., D.M.), and Microbiology and Immunology (O.S., M.A.B.), McGill University, Montreal; and Johns Hopkins University, Baltimore (D.W.D.).
Background:
Prevention of drug-resistant tuberculosis is a global health priority. However, trials evaluating the effectiveness of treating Mycobacterium tuberculosis infection among contacts of persons with drug-resistant tuberculosis are lacking.
Methods:
We conducted a double-blind, randomized, controlled trial comparing 6 months of daily levofloxacin (weight-based doses) with placebo to treat M. tuberculosis infection. The trial population comprised household contacts of persons with bacteriologically confirmed rifampicin-resistant or multidrug-resistant (MDR) tuberculosis in Vietnam. Contacts of any age with a positive tuberculin skin test or immunologic impairment were eligible. The primary end point was bacteriologically confirmed tuberculosis within 30 months. Secondary end points included grade 3 or 4 adverse events, death from any cause, and acquired drug resistance.
Results:
Of 3948 persons screened for eligibility, 61 (1.5%) had coprevalent tuberculosis (defined as active tuberculosis disease diagnosed before randomization) and 2041 underwent randomization. Of these 2041 participants, 1995 (97.7%) completed 30 months of follow-up, had a primary end-point event, or died. Confirmed tuberculosis occurred in 6 participants (0.6%) in the levofloxacin group and 11 (1.1%) in the placebo group (incidence rate ratio, 0.55; 95% confidence interval [CI], 0.19 to 1.62); this difference was not significant. There was little difference in grade 3 or 4 adverse events between the two groups (risk difference, 1.0 percentage point; 95% CI, -0.3 to 2.4). Adverse events of any grade were reported in 306 participants (31.9%) taking levofloxacin and 125 (13.0%) taking placebo (risk difference, 18.9 percentage points; 95% CI, 14.2 to 23.6). No acquired fluoroquinolone resistance was observed.
Conclusions:
Although the incidence of tuberculosis was lower in the levofloxacin group than in the placebo group at 30 months, the difference was not significant. (Funded by the National Health and Medical Research Council of Australia; VQUIN MDR Australia New Zealand Clinical Trials Registry number, ACTRN12616000215426.).
More Related Videos
06:26Author Spotlight: Optimizing CFU Determination for Efficient Assessment of TB Vaccine Efficacy and Antigen Presentation Analysis
Published on: July 28, 2023
07:50Author Spotlight: Scalable Drug Screening Protocol for Efficient Discovery of M. abscessus Treatments
Published on: October 25, 2024
Related Concept Videos
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
01:26Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...