Shorter oral Bedaquiline-containing MDR/RR-TB regimen: Evidence

The preliminary analysis suggested a 13% higher treatment success rate (73% all-oral versus 60% standardized Injectable shorter regimen success rates) among the shorter oral Bedaquiline-containing Multi-drug Resistant (MDR)/ Rifampicin Resistant (RR) -TB regimen group as compared to the standardized shorter injectable-containing regimen. 

• There was a lower loss to follow-up than a standardized shorter injectable-containing regimen.
• No marked difference in outcomes was observed between a shorter all-oral Bedaquiline-containing regimen and an injectable-free longer regimen containing Bedaquiline.
• However, relatively modest beneficial effects were noted in shorter oral regimens favouring the use of the shorter regimen.
• This evidence on shorter oral Bedaquiline-containing MDR/ RR-TB regimen is primarily based on the programmatic data from South Africa, which was reviewed by the World Health Organization (WHO) for the performance of standardized shorter regimen whereby the injectable agent was replaced by Bdq, in combination with Lfx (or Mfx), Cfz, Hh , E, Z and Eto (or Pto).

Resources

• Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, March 2021.