Sirturo (bedaquiline) / J&J, Pharmstandard - LARVOL DELTA

Multidrug-Resistant Tuberculosis Presenting With Severe Intestinal Involvement and Cecal Volvulus (ACG 2026) - "She was started on BPaLM therapy (bedaquiline, pretomanid, linezolid, and moxifloxacin). Figure: Figure 2. CT abdomen/pelvis showing marked cecal dilation with findings consistent with cecal volvulus."

Cough • Gastrointestinal Disorder • Infectious Disease • Inflammation • Respiratory Diseases • Tuberculosis

Altered physiology of drug-resistant Mycobacterium tuberculosis restricts adaptation to host-relevant conditions and produces condition-dependent collateral vulnerabilities. (PubMed, mBio) - "This work shows that (i) the fitness costs of antibiotic resistance in M. tuberculosis are highly variable and can be exacerbated or alleviated depending on the media carbon source, (ii) genetically unrelated resistance mutations have overlapping phenotypes and metabolic dysregulation, (iii) the growth of bedaquiline- and rifampicin-resistant mutants was impaired on host-relevant carbon sources, and (iv) resistance mutants have condition-specific collateral antibiotic susceptibilities, with rifampicin-resistant mutants being hypersusceptible to ATP synthase inhibitors when grown under conditions that require propionate metabolism. We also show that unrelated antibiotic-resistant strains share similar metabolic defects, which can be exploited to improve antimicrobial susceptibility. Overall, this work demonstrates that drug resistance reshapes the physiology of M. tuberculosis in growth-dependent ways, having major implications for our understanding of how drug resistance..."

Journal • Infectious Disease • Metabolic Disorders • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Development, Validation, and Clinical Application of a Simultaneous Quantification Method of Seventeen Antituberculosis Drugs in Plasma, Serum, or Saliva Using LC-MS/MS. (PubMed, Ther Drug Monit) - "This validated LC-MS/MS method allows simultaneous analysis of multiple anti-TB drugs in plasma, serum, and saliva, facilitating clinical and research applications. The method has been successfully applied in clinical practice."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

The safety and efficacy of different anti-tuberculosis regimens containing Lzd for RR/MDR/Pre-XDR-TB patients in China. (PubMed, Medicine (Baltimore)) - "Patients were divided into 3 groups: linezolid (Lzd) + bedaquiline (Bdq) containing group (regimen A), Lzd + delamanid (Dlm) containing group (regimen B), and Lzd + other drugs containing group (regimen C, not containing Bdq or Dlm)...88.2% (30/34) of the Dlm group used Lzd-Dlm-clofazimine (Cfz)-cycloserine (Cs) containing regimens...Lzd-Dlm-Cfz-Cs containing regimens may serve as promising candidate regimens for future research on rifampicin-resistant tuberculosis. Multicenter prospective studies with longer follow-up and definitive treatment outcomes are needed to establish comparative effectiveness or treatment superiority of these regimens."

Journal • Retrospective data • Cardiovascular • Heart Failure • Human Immunodeficiency Virus • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Drug-resistance profiles, population structure, genomic clustering, and temporal trends in drug resistance among Mycobacterium tuberculosis complex isolates in Ukraine, 2019-2023: a multicentre cohort study. (PubMed, Lancet Reg Health Eur) - "Ukraine has a high burden of rifampicin-resistant (RR) tuberculosis (TB)...Among 3040 multidrug-resistant (MDR) isolates, 1101/3040 (36.2%) had WGS-inferred fluoroquinolone (FQ) resistance and 78/3040 (2.6%) were classified as extensively DR-TB (XDR-TB); 57 had bedaquiline resistance, 32 had linezolid resistance, and 11 had resistance to both drugs...Temporal trends may reflect concurrent epidemiological, diagnostic, and health-system changes. NIAID/USCRDF; BMBF; Deutsche Forschungsgemeinschaft; EvoLUNG."

Journal • Infectious Disease • Novel Coronavirus Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Treatment outcomes for people with multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB) : global findings (ERS 2026) - " detection and treatment coverage of MDR/RR-TB remain low, but treatment success has improved since 2012, concurrent with increased global use of all-oral regimens with effective drugs like bedaquiline and linezolid. Access continues to improve, and 6-month MDR/RR-TB regimens are now used in ~100 countries, with >34,000 people started on them in 2024, a 20-fold increase compared with 2022. With further scale-up of these regimens, cure rates can approach those for rifampicin-susceptible TB."

Clinical • Infectious Disease • Respiratory Diseases • Tuberculosis

Adherence to New Drug Regimens in MDR-TB Programmatic Management: Insights from a Retrospective Mixed-Method Study in Bangladesh (ERS 2026) - "Bedaquiline (BDQ) and delamanid (DLM), conditionally approved for MDR-TB, offer new opportunities to improve outcomes...Rifampicin-resistant patients underwent confirmation and second-line DST or LPA before enrollment...These findings demonstrate the feasibility and effectiveness of BDQ- and DLM-based regimens under programmatic conditions, despite notable AEs. Strengthened pharmacovigilance and patient-centred monitoring remain essential to optimize MDR/XDR-TB management and guide future policy decisions."

Adherence • Retrospective data • Acute Kidney Injury • Hematological Disorders • Infectious Disease • Nephrology • Renal Disease • Respiratory Diseases • Tuberculosis

Evaluation of the use of ceftazidime-avibactam and bedaquiline in the treatment of M. abscessus-pulmonary disease (ERS 2026) - "Our small cohort suggests that CA+Car+BDQ may be more efficacious and better tolerated than current first line regimens for MA-PD. Further studies are needed to allow for greater understanding of the safety and efficacy of this regimen."

Bronchiectasis • Cystic Fibrosis • Genetic Disorders • Immunology • Infectious Disease • Non‐Cystic Fibrosis Bronchiectasis • Pulmonary Disease • Respiratory Diseases

A Pilot Study on the Utility of Whole Genome Sequencing for Detecting Drug Resistance in Mycobacterium tuberculosis in the Current Scenario. (PubMed, Indian J Med Microbiol) - "Resistance detected by WGS was as follows: Isoniazid 23(39.6%), Rifampicin 21(36.2%), FQs 21(36.2%), Ethambutol 18(31%), Linezolid 12(20.6%), Streptomycin 8(13.8%), Kanamycin 6(10.3%), Amikacin and Capreomycin 5(8.6%), Para-amino salicylic acid 1(1.7%) and Ethionamide 1(1.7%). No resistance was detected to Pyrazinamide, Bedaquiline, Clofazimine, Delamanid and Pretomanid...Intermediate Resistance (IR) and potential novel mutations were observed in a few cases, Overall accuracy for first-line drugs between pDST vs WGS was >98% &pDST vs LPA >95%, while for second-line drugs accuracy was >96% and >90% respectively. IR and potential novel mutations should be followed up closely to understand their clinical significance."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Macrolide-resistant Mycobacterium avium complex pulmonary disease: A narrative review. (PubMed, J Clin Tuberc Other Mycobact Dis) - "The combination of lung resection surgery with or without amikacin, along with continued ethambutol use, has been associated with improved outcomes relative to regimens without these...For instance, clofazimine and minocycline have both been proposed as a replacement for rifampicin. Bedaquiline has also been suggested as rescue therapy. This narrative clinical review describes the prevalence of MR-MAC-PD, resistance mechanisms, clinical management strategies, and provides a brief overview of the drug pipeline for MAC-PD, aiming to inform clinical practice and guide evidence-based management."

Journal • Review • Infectious Disease • Pulmonary Disease • Respiratory Diseases

Anaemia, hypoalbuminemia, and risk of cycloserine-associated neuropsychiatric toxicity in a shortened oral regimen for multidrug/rifampicin-resistant TB. (PubMed, IJTLD Open) - "Baseline anaemia and hypoalbuminemia were associated with increased neuropsychiatric toxicity risk during treatment with a cycloserine-containing regimen. Whether these associations are specific to cycloserine merits further study."

Journal • Anemia • CNS Disorders • Epilepsy • Hematological Disorders • Infectious Disease • Pain • Psychiatry • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Real-world treatment outcomes and adverse events during BPaLM therapy for rifampicin-resistant TB. (PubMed, IJTLD Open) - "BPaLM/BPaL achieved excellent early effectiveness but required frequent regimen modifications. Successful implementation of short-course RR/MDR-TB regimens requires anticipatory toxicity monitoring, flexible regimen management, and robust treatment support systems."

Adverse events • HEOR • Journal • Real-world evidence • Hematological Disorders • Infectious Disease • Pain • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Pharmacokinetic Study to Evaluate Anti-mycobacterial Activity of TMC207 in Combination With Background Regimen (BR) of Multidrug Resistant Tuberculosis (MDR-TB) Medications for Treatment of Children/Adolescents With Pulmonary MDR-TB (clinicaltrials.gov) - P2 | N=60 | Suspended | Sponsor: Janssen Research & Development, LLC | Recruiting ➔ Suspended

Trial suspension • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Multicenter Efficacy and Safety Evaluation Study of Ultra-Short Regimens for Drug-Resistant Pulmonary Tuberculosis (ChiCTR) - P=N/A | N=330 | Not yet recruiting | Sponsor: Shenzhen Third People's Hospital; Shenzhen Third People's Hospital

New trial • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

BARRIERS TO TIMELY IMPLEMENTATION OF BEDAQUILINE-BASED REGIMEN FOR MULTIDRUG-RESISTANT TB (CHEST 2026) - No abstract available

Feasibility of the Application of a New Six-month Treatment for Multidrug-resistant Tuberculosis (MDR-TB) Patients in France (FAST-MDR) (clinicaltrials.gov) - P3 | N=55 | Recruiting | Sponsor: Assistance Publique - Hôpitaux de Paris | Not yet recruiting ➔ Recruiting | Initiation date: Apr 2026 ➔ Sep 2026

Enrollment open • Trial initiation date • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Efficacy of quabodepistat alone and in combination with delamanid and bedaquiline against Mycobacterium tuberculosis in an NHP model evaluated by [18F] FDG PET/CT and bacterial burden. (PubMed, Antimicrob Agents Chemother) - "Bedaquiline (B), delamanid (D), and pretomanid (P) are used in combination regimens with other anti-TB drugs for MDR-TB; however, agents with novel mechanisms of action are needed...Additionally, the activities of D and P monotherapies were similar in this model. The evaluation of these agents in the marmoset TB model supports further investigation of Q as a component of shorter TB regimens."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Linezolid in the era of bedaquiline-pretomanid-linezolid-based regimens: an indispensable challenge. (PubMed, Respir Res Clin Pract) - No abstract available

Journal

Structural and Mechanistic Studies of ADEPs Yield Potent Antibacterials and a Drug Formulation Strategy for Tuberculosis. (PubMed, J Med Chem) - "Our observation that ADEP 19 caused a reduction in intracellular ATP in Mtb suggested potential synergy of ADEPs with bedaquiline (BDQ), a tuberculosis drug that inhibits ATP synthesis. Checkerboard assays and experiments in a zebrafish TB model affirmed synergy between ADEP 19 and BDQ that could be leveraged to address BDQ-associated cardiotoxicity."

Journal • Cardiovascular • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Nitric oxide enhances antimicrobial effects of clofazimine against Mycobacterium abscessus (NACFC 2026) - "We also performed 3-D checkerboard assays in one laboratory strain (ATCC 19977) combining CFZ + dNO with seven antibiotics (amikacin, cefoxitin, linezolid, tedizolid, bedaquiline, omadacycline, and imipenem). Inhaled NO is a promising adjunctive therapy for MAB, particularly when combined with CFZ. However, NO-antibiotic interactions are complex, and further research is needed to guide the selection of optimal antibiotic regimens."

Cardiovascular • Infectious Disease • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases

Guidelines for off-label use of anti-tuberculosis drugs (PubMed, Zhonghua Jie He He Hu Xi Za Zhi) - "NAT2 genotype-inferred acetylator phenotype may support individualized dose adjustment together with TDM, efficacy, and safety assessments (2, B).Recommendation 7: Off-label rifampicin use includes a 3-month regimen of isoniazid and rifampicin (3HR) (1, B) or a 4-month regimen of rifampicin (4R) (2, B) for tuberculosis preventive treatment; individualized high-dose use in TBM or investigational use in drug-susceptible pulmonary tuberculosis (2, C); local administration as adjunct therapy only (2, D); and use during pregnancy, including early pregnancy, after individualized benefit-risk assessment (2, C).Recommendation 8: Based on pharmacokinetic and safety data from Chinese populations, the 3H₂P₂ regimen-isoniazid 500-600 mg, plus rifapentine, 450-600 mg, twice weekly for 3 months-is recommended for tuberculosis preventive treatment (1, B).Recommendation 9: Levofloxacin is a key drug for fluoroquinolone-susceptible MDR/RR-TB (1, B); it may also be used for..."

Journal • Cardiovascular • CNS Disorders • Epilepsy • Heart Failure • Hepatology • Infectious Disease • Liver Failure • Metabolic Disorders • Pain • Pulmonary Disease • Renal Disease • Respiratory Diseases • Tuberculosis • NAT2

Pan-TB regimens: too good to be true? (PubMed, Expert Rev Anti Infect Ther) - No abstract available

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Treatment outcomes and factors associated with unfavorable outcomes among drug-resistant tuberculosis patients treated with a bedaquiline-based oral regimen. (PubMed, Monaldi Arch Chest Dis) - "After adjustment for diabetes mellitus and BCG vaccination history, previous TB treatment remained an independent predictor of unfavorable treatment outcomes (aOR = 11.47; 95% CI: 4.19-31.41; p<0.001). These findings indicate that patients with a history of previous TB treatment are at substantially greater risk of unfavorable treatment outcomes and underscore the need for closer monitoring and more comprehensive management strategies to improve treatment success."

Journal • Diabetes • Infectious Disease • Metabolic Disorders • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Fluctuating environmental adaptation shapes antibiotic survival in Mycobacterium tuberculosis. (PubMed, J Microbiol) - "Notably, under identical final condition with cholesterol as a sole carbon source, populations adapted to a stable environment exhibited higher survival following bedaquiline and rifampicin treatment than populations exposed to fluctuating environments. These findings suggest that stable environments promote the optimization of growth and stress-response programs, whereas environmental fluctuations limit such optimization despite potentially increasing phenotypic heterogeneity and a possibility of survival. Together, our results identify environmental history as an important determinant of antibiotic survival in Mtb and highlight the need to consider dynamic host-like environments when investigating tuberculosis physiology and drug responses."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Genomic and structural insights into the atpB L173I substitution: modulation of the F₀ rotor architecture in Mycobacterium tuberculosis ATP synthase and altered Bedaquiline binding dynamics. (PubMed, World J Microbiol Biotechnol) - "These perturbations provide a mechanistic rationale for reduced BDQ susceptibility, arising from altered interfacial dynamics rather than complete abrogation of drug binding. This integrative genomic-structural framework advances our understanding of ATP synthase-mediated resistance in M. tuberculosis."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis