BPaL for Rifampin-Resistant Tuberculosis

In a retrospective analysis of patients treated in the U.S., no initial failures occurred after a 6-month oral course of bedaquiline, pretomanid, and linezolid.

In 2019, a 6-month oral regimen of bedaquiline, pretomanid, and linezolid (BPaL) was approved in the U.S. for patients with rifampin-resistant tuberculosis (RR-TB) or those intolerant to rifampin based on the NIX-TB trial conducted in South Africa (NEJM JW Infect Dis Mar 14 2023 and Clin Infect Dis 2023 Feb 21; [e-pub]). To assess the U.S. experience with BPaL, a multicenter team compiled data retrospectively from August 2019 through April 2022. Among 68 patients in 12 states and territories, >75% had pulmonary TB, and 61% had multidrug-resistant infection. Although doses of bedaquiline and pretomanid were fixed, linezolid dosing was determined by providers, and therapeutic drug monitoring (TDM) was employed. Dosage adjustments were typical…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

BPaL for Rifampin-Resistant Tuberculosis

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Reviewing Author