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Evaluation of the Efficacy and Tolerability of Bedaquiline in Drug-Resistant Tuberculosis

Trivedi HH, Tripathi S, Patel P, Balat MC, Shaikh MS, Patil N

Cureus, 2026

64 participants

Abstract

INTRODUCTION: Multidrug-resistant tuberculosis (TB) poses a serious threat to public health globally because of limited treatment options and high levels of antimicrobial resistance. Bedaquiline is an important component of contemporary multidrug treatment regimens for drug-resistant TB. This study aimed to evaluate treatment outcomes and tolerability among patients receiving a bedaquiline-containing regimen, including sputum conversion, laboratory parameters, adverse drug reactions (ADRs), and treatment compliance.

MATERIALS AND METHODS: The study was a hospital-based prospective observational study conducted among 64 patients with drug-resistant TB who attended the drug-resistant TB clinic at Zydus Medical College and Hospital, Dahod, from April 2024 to September 2025. Patients on a bedaquiline-based regimen were followed up monthly to assess sputum conversion, laboratory tests, ADRs, and treatment compliance.

RESULTS: Among 64 patients with drug-resistant TB, sputum conversion was achieved in 61 (95.3%), with no significant association between conversion and baseline demographic or clinical characteristics (all p > 0.05). Universal rifampicin resistance (100%) and high levels of isoniazid resistance were observed, whereas susceptibility was observed in 98.4% of isolates to injectable anti-TB drugs and in 64.1% to moxifloxacin. These in vitro drug susceptibility findings should not be interpreted as evidence of comparative clinical efficacy. Follow-up demonstrated…

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