Tuberculosis is still one of the biggest health burdens facing Indonesia. Every year, hundreds of thousands of citizens are diagnosed, and some of them have to take a long, tiring path: taking medication every day, for months, sometimes up to more than a year in drug-resistant cases. At this point, good news came from Yogyakarta, five Gadjah Mada University students developed a new approach that has the potential to change the face of TB treatment in the future: a system for delivering the antibiotic drug levofloxacin via inhalation, which they namedLevocross.
Why This Matters
To many people outside the world of health, TB may sound like a disease for which "there is a cure." However, the reality on the ground is much more complicated. Both Drug Sensitive TB and Drug Resistant TB still rely on oral medication which must pass through the digestive tract before finally, if lucky, reaching sufficient concentrations in the lungs, the organ that most often harbors bacteria.Mycobacterium tuberculosis. The large size of the tablet, the side effects of nausea and vomiting, and the long duration of treatment, make for a tough combination to endure. Not a few patients end up stopping midway, a decision that can secretly make the situation worse, because incomplete discontinuation of treatment risks giving rise to drug resistance that is more difficult to treat.
This is where Levocross' ideas find their relevance. Instead of letting the drug take the long journey through the digestive system before reaching the lungs, this team of students tried a more direct route: delivering antibiotics through the breath, directly to the affected organs.
The Science Behind the Breakthrough
What makes this research interesting is not only the idea, but also how it was designed. Levocross Team, Alphatar Magnus Jonathan Tambunan, Emeliana Putri Ayu Ningsih, and Ernestus Revan Yogantara Arjuna from the Faculty of Medicine, Public Health and Nursing, together with Desrika Dwi Handayani and Fatharani Hasya Tsabita from the Faculty of Pharmacy, under the guidance of Dr.rer.nat. Ronny Martien, M.Sc., started from a fairly basic biological fact: TB bacteria often hide in alveolar macrophages, the body's defense cells which are actually located in the lungs. This means that the ideal treatment does not simply deliver the drug to the lungs, but has the potential to reach the specific cells where the bacteria hide.
To address this challenge, levofloxacin was combined with nano-sized carrier technology and hyaluronic acid. The process uses methodshot emulsification-ultrasonication, where ultrasonic waves convert a mixture of ingredients into nano-sized particles, before hyaluronic acid is added to support its delivery function. This formulation is then tested from various angles: particle size and uniformity, drug capacity that can be successfully loaded, stability, drug release pattern, and its ability to form an aerosol when passed through a nebulizer, an important step to ensure the drug can actually be inhaled effectively. This research is part of the Student Creativity Program in Exact Research (PKM-RE) 2026, and is currently still at the data collection and analysis stage, including in vitro testing to see the interaction of the formulation with cells.
Notes from the TB Control Policy and Program Side
As part of a community that works every day to support the elimination of TB, we see innovations like Levocross as an important reminder: the solution to TB is not just about finding new drugs, but also about finding alternatives to get existing drugs to patients. So far, almost all second-line TB therapies, including levofloxacin, are only available in oral form. There are no inhalation preparations currently available for this indication. If in the future this kind of research successfully passes all stages of clinical trials and is proven to be safe and effective, the potential impact is real: treatment that is more targeted to target organs, possibly lower systemic side effects, and, which is no less important, a treatment experience that is more tolerable for patients, so that the risk of drug withdrawal can be reduced.
However, it is important to put this optimism in proportion. Levocross is currently still at the basic research stage, far from being a drug that is ready for use by patients. The road to clinical trials, let alone official distribution, is still long and requires rigorous scientific proof at every stage. For this reason, support for the sustainability of this research is crucial, whether in the form of funding, academic assistance, or cross-institutional collaboration, so that the in vitro stage findings do not stop as mere academic achievements, but can continue to be pushed towards pre-clinical and clinical testing.
Maintaining Momentum Towards TB Elimination by 2030
Indonesia has set a target of eliminating TB by 2030, an ambitious target considering the still high caseload. Achieving this requires more than just case finding and standard treatment, it also requires innovation that dares to challenge old ways of delivering health services to the community. The work of the nation's children such as Levocross shows that this spirit is alive among the younger generation, including those still pursuing undergraduate education.
We at Stop TB Partnership Indonesia welcome this initiative and encourage the health research ecosystem, universities, government, pharmaceutical industry, and funding institutions, to jointly oversee the journey of Levocross and other similar research. Because in the end, the fight against tuberculosis is not just about finding the right compound, but also about ensuring that every patient, wherever they are, can access treatment that is not only effective, but also worth living to the end.
Reference source: Gadjah Mada University, "UGM Students Develop Innovation for Delivery of Tuberculosis Drugs to the Lungs Through Inhalation," 31 August 2026.
