Bedaquiline can act as core drug in a standardised treatment regimen for fluoroquinolone-resistant rifampicin-resistant tuberculosis

Previous studies showed that a fluoroquinolone-based short treatment regimen is effective for the treatment of tuberculosis (TB) resistant to the most important first-line TB drug, rifampicin. How to replace the fluoroquinolone in case of resistance to fluroquinolone, the most potent second-line drug, is unknown. Our findings show that replacing a fluoroquinolone by bedaquiline in the same short treatment regimen resulted in an early and sustained treatment response. When linezolid was used to the strengthen the fluoroquinolone-based regimen during the first treatment months the same early effect was not shown. Our findings suggest that bedaquiline, but probably not linezolid, can act as the treatment's core drug and can assure relapse-free cure. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflicts of interest: B.C. de Jong reports grant funding from USAID for the STREAM trial on Bedaquiline for MDR-TB; and membership of a Panacea scientific advisort board, both within the 36 months prior to manuscript submission. All other authors declare no conflicts of interest.