Simplifying Drug-Resistant TB Treatment in Vulnerable Groups

In 2022, the World Health Organization updated guidelines for treating rifampin-resistant pulmonary tuberculosis (TB) to recommend a 6-month regimen of bedaquiline, pretomanid, linezolid, and moxifloxacin. Given that pretomanid is not recommended for children younger than 14 or women who are pregnant or breast-feeding, South African investigators studied 400 patients who had pulmonary tuberculosis with rifampin resistance with or without further resistance to isoniazid and fluoroquinolones; 30 participants were ages 8−17, and 9 were pregnant women. Patients were randomized to either a 6-month regimen of bedaquiline, linezolid, delamanid, and levofloxacin or clofazimine or both or to a 9-month standard-of-care treatment.