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Children at Risk of Multidrug-Resistant TB Get Prevention Option

Doctors check X-ray film of a drug-resistant tuberculosis patient. Photographer: Nhac Nguyen/AFP/Getty Images (Nhac Nguyen/AFP/Photographer: Nhac Nguyen/AFP/Ge)

(Bloomberg) -- In a win against one of the top causes of death in children, a newly peer-reviewed clinical trial shows levofloxacin significantly cuts the risk of those younger than five developing multidrug-resistant tuberculosis.

The oral antibiotic taken once daily for six months was safe and well tolerated in children, reducing their chances of getting this form of TB by 56%, according to the study published in the New England Journal of Medicine.

Authorities estimate about 2 million children worldwide carry the bacteria that causes this often deadly type of TB, though less than 20% are currently diagnosed and treated. Offering a preventive treatment is critical in improving testing rates.

Despite “major advances” in recent years in treating MDR-TB disease, “no rigorous evidence from clinical trials on how to prevent drug-resistant TB” has materialized until now, said Anneke Hesseling, the principal investigator of the TB-CHAMP trial at Stellenbosch University.

Like other infectious diseases, TB is usually spread among households. If doctors treat only one member of a family, the battle to fight drug-resistant TB could already be lost.

Doctors gave levofloxacin to 453 children in South Africa exposed to an adult with MDR-TB in their household. Five developed the illness, compared with 12 in the placebo control group. Only one child given the drug had joint pain, a side effect that is more common in other treatments. 

“MDR-TB remains challenging to treat, and children have always been the most neglected of all patients, with access to newer medicines lagging behind adults,” said James Seddon, a co-principal investigator.

The trial showed savings of $11.3 million for TB programs. A similar study conducted in Vietnam that focused on adults and adolescents had comparable findings. 

The reports come as Africa struggles with an array of diseases that shorten lives, dampen productivity and hold back economic growth. More than 400,000 people on the continent die every year from tuberculosis. 

Unitaid, the South African Medical Research Council and the UKRI Medical Research Council were among the funders of the South African trial.

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