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New developments in the treatment of drug-resistant tuberculosis: clinical utility of bedaquiline and delamanid

Authors Brigden G, Hewison C, Varaine F

Received 19 May 2015

Accepted for publication 8 July 2015

Published 30 October 2015 Volume 2015:8 Pages 367—378

DOI https://doi.org/10.2147/IDR.S68351

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Rekha Dhanwani

Peer reviewer comments 3

Editor who approved publication: Professor Suresh Antony

Grania Brigden,1 Cathy Hewison,2 Francis Varaine2

1Access Campaign, Médecins Sans Frontières, Geneva, Switzerland; 2Medical Department, Médecins Sans Frontières, Paris, France

Abstract: The current treatment for drug-resistant tuberculosis (TB) is long, complex, and associated with severe and life-threatening side effects and poor outcomes. For the first time in nearly 50 years, there have been two new drugs registered for use in multidrug-resistant TB (MDR-TB). Bedaquiline, a diarylquinoline, and delamanid, a nitromidoxazole, have received conditional stringent regulatory approval and have World Health Organization interim policy guidance for their use. As countries improve and scale up their diagnostic services, increasing number of patients with MDR-TB and extensively drug-resistant TB are identified. These two new drugs offer a real opportunity to improve the outcomes of these patients. This article reviews the evidence for these two new drugs and discusses the clinical questions raised as they are used outside clinical trial settings. It also reviews the importance of the accompanying drugs used with these new drugs. It is important that barriers hindering the use of these two new drugs are addressed and that the existing clinical experience in using these drugs is shared, such that their routine-use programmatic conditions is scaled up, ensuring maximum benefit for patients and countries battling the MDR-TB crisis.

Keywords: MDR-TB, XDR-TB, tuberculosis drugs, group 5 drugs

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