Population implications of the use of bedaquiline in people with extensively drug-resistant tuberculosis: are fears of resistance justified?

by Amber Kunkel, Jennifer Furin, Ted Cohen
Lancet Infect Dis 2017 – Published Online May 19, 2017

5 pp. 216 kB
http://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(17)30299-2.pdf

Global rollout of the new antituberculosis drug bedaquiline has been slow, in part reflecting concerns about spread of bedaquiline resistance. Acquired resistance to bedaquiline is especially likely in patients with extensively drug-resistant (XDR) tuberculosis. However, the very high mortality rates of patients with XDR not receiving bedaquiline, and promising cohort study results, suggest these patients also have greatest need for the drug. In this Personal View, the authors argue that resistance concerns should not forestall use of bedaquiline in patients with XDR tuberculosis.

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