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Bedaquiline: A New Hope for Shorter and Better Anti-Tuberculosis Regimens

[ Vol. 13 , Issue. 1 ]

Author(s):

Niccolò Riccardi*, Filippo Del Puente, Federica Magnè, Lucia Taramasso and Antonio Di Biagio   Pages 3 - 11 ( 9 )

Abstract:


Background: In 2014, an estimated 1.8 million people died from Mycobacterium tuberculosis (MTB); moreover, 680,000 people developed multidrug-resistant TB (MDRTB).

Methods: Currently available anti-MDR and XDR regimens are long-lasting and expensive, need high adherence and are undermined by a high frequency of adverse drug events, thus leading to a low success rate; furthermore, in the last 50 years only two new molecules, bedaquiline (BDQ) and delamanid, have been approved and released for the treatment of MDR-TB.

Results: BDQ, patent number US 7,498,343B2, is a diarylquinoline anti-mycobacterial drug, active regardless of the state of MTB; in fact, its efficacy is conserved against replicating and non-replicating bacilli, despite extracellular or intracellular location. BDQ has been approved by the Food and Drug Administration (FDA) only for combination treatment of pulmonary multidrug-resistant tuberculosis (MDR-TB), in adult patients, when an effective treatment cannot be provided otherwise due to resistance or poor tolerability; however, due to high bactericidal activity, BDQ may be used in future to treat extrapulmonary tuberculosis and Mycobacterium other than tuberculosis (MOTT) infection.

Conclusion: BDQ may play a major role to get closer to TB eradication and to ensure higher retention in care, even in fully susceptible MTB strains and against non-replicating mycobacteria in latent-TB, providing an alternative to standard regimen.

Keywords:

Tuberculosis, Bedaquiline, MDR-TB, intracellular, standard regimen, strains.

Affiliation:

Infectious Disease Department, IRCCS AOU San Martino IST, University of Genoa, Genoa, Infectious Disease Department, IRCCS AOU San Martino IST, University of Genoa, Genoa, Infectious Disease Department, IRCCS AOU San Martino IST, University of Genoa, Genoa, Infectious Disease Department, IRCCS AOU San Martino IST, University of Genoa, Genoa, Infectious Disease Department, IRCCS AOU San Martino IST, University of Genoa, Genoa

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