Is bedaquiline as effective as fluoroquinolones in the treatment of multidrug-resistant tuberculosis?. Issue 2 (23rd June 2016)

• Record Type: Journal Article
• Authors: Guglielmetti, Lorenzo; Le Dû, Damien; Veziris, Nicolas; Caumes, Eric; Marigot-Outtandy, Dhiba; Yazdanpanah, Yazdan; Robert, Jérôme; Fréchet-Jachym, Mathilde
• Is Part Of: European respiratory journal. Volume 48:Issue 2(2016)
• Page Start: 582
• Page End: 585
• Publication Date: 2016-06-23
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.00411-2016
• Languages: English
• ISSNs: 0903-1936

Abstract

Bedaquiline (Bdq) is approved for the treatment of multidrug-resistant (MDR) tuberculosis (TB). In a phase IIb trial, Bdq allowed a significant reduction in time to culture conversion and improved outcome in MDR-TB patients [1, 2]. Preliminary reports of Bdq compassionate use have shown promising results [3–5]. However, in an early bactericidal activity (EBA) study, the association of moxifloxacin (Mfx) with PA-824 and pyrazinamide showed better activity than Bdq-based associations [6]. In addition, resistance to fluoroquinolones (Fq) has been associated with poorer outcome in MDR-TB before Bdq use [7]. These data reinforce the pivotal role of Fq. Comparing Bdq to Fq in interventional studies is challenging. Indeed, the paucity of drugs available for MDR-TB treatment, and the need for combination therapy, often impose the need to use all available drugs. Bedaquiline and fluoroquinolone treatments give similar culture conversion rates at 6 months in MDR-TB patients http://ow.ly/oqVY300mJCy