title: Treatment for LTBI in contacts of MDR-TB patients, Federated States of Micronesia, 2009-2012.
abstract: METHODS
  Few studies have shown the operational feasibility, safety, tolerability, or outcomes of multidrug-resistant latent tuberculous infection (MDR LTBI) treatment. After two simultaneous multidrug-resistant tuberculosis (MDR-TB) outbreaks in Chuuk, Federated States of Micronesia, infected contacts were offered a 12-month fluoroquinolone (FQ) based MDR LTBI treatment regimen.
  
  
  METHODS
  Between January 2009 and February 2012, 119 contacts of MDR-TB patients were followed using a prospective observational study design. After MDR-TB disease was excluded, 12 months of daily FQ-based preventive treatment of MDR LTBI was provided by directly observed therapy.
  
  
  RESULTS
  Among the 119 infected contacts, 15 refused, while 104 began treatment for MDR LTBI. Of the 104 who initiated treatment, 93 (89%) completed treatment, while 4 contacts discontinued due to adverse effects. None of the 104 contacts who undertook MDR LTBI treatment of any duration developed MDR-TB disease; however, 3 of 15 contacts who refused and 15 unidentified contacts developed MDR-TB disease.
  
  
  CONCLUSIONS
  Providing treatment for MDR LTBI can be accomplished in a resource-limited setting, and contributed to preventing MDR-TB disease. The Chuuk TB program implemented treatment of MDR LTBI with an 89% completion rate. The MDR LTBI regimens were safe and well tolerated, and no TB cases occurred among persons treated for MDR LTBI.
authors.affiliation: <label>*</label>Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: S
authors.initials: S
authors.lastname: Bamrah
authors.affiliation: <label>*</label>Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: R
authors.initials: R
authors.lastname: Brostrom
authors.affiliation: <label><sup>‡</sup></label>Chuuk State TB Program, Ministry of Health, Chuuk, Federated States of Micronesia.
authors.forename: F
authors.initials: F
authors.lastname: Dorina
authors.affiliation: <label><sup>‡</sup></label>Chuuk State TB Program, Ministry of Health, Chuuk, Federated States of Micronesia.
authors.forename: L
authors.initials: L
authors.lastname: Setik
authors.affiliation: <label>*</label>Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: R
authors.initials: R
authors.lastname: Song
authors.affiliation: <label><sup>¶</sup></label>Tuberculosis Control Section, San Francisco Department of Public Health, San Francisco, California, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Kawamura
authors.affiliation: <label>*</label>Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: A
authors.initials: A
authors.lastname: Heetderks
authors.affiliation: <label>*</label>Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: S
authors.initials: S
authors.lastname: Mase
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016358:Contact Tracing; D023801:Directly Observed Therapy; D004196:Disease Outbreaks; D005260:Female; D024841:Fluoroquinolones / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D055985:Latent Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D008297:Male; D008849:Micronesia / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies; D016312:Treatment Refusal; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D024841:Fluoroquinolones