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There have been both wins and losses in the battle against tuberculosis (TB). Certainly, the development of drug resistance, sometimes against multiple agents, has been a major factor in disease management and infection control. Bedaquiline is the first drug with a new mechanism of action to be approved in 40 years for use in treating multidrug-resistant TB (MDR-TB).
In a recent manufacturer-sponsored, multinational, double-blind trial, 160 adults with newly diagnosed, sputum smear–positive, pulmonary MDR-TB were randomized to receive bedaquiline (400 mg once daily for 2 weeks, then 200 mg 3 times weekly for 22 weeks) or placebo in addition to a second-line background regimen consistent with WHO recommendations for treatment of MDR-TB. Follo…