ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025
Bedaquiline Resistance and Treatment Outcomes Among Patients With Tuberculosis Previously Exposed to Bedaquiline in India: A Multicentric Retrospective Cohort Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- When are Uncontrolled Trials in TB Scientifically and Ethically Justified: Borrowing Wisdom From Early AIDS Clinical Trials.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- We Are Underprepared for Bedaquiline Resistance: A Call for Clinical and Programmatic Readiness.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Rising bedaquiline resistance: exploring potential causes and next steps.The European respiratory journal · 2026Article
- Profiling of BDQ-induced transcriptome suggests amino acid metabolism and stress responses as alternate mechanisms contributing to BDQ tolerance inMicrobiology spectrum · 2026Article
- Antimicrobial Peptides Against Antimicrobial-Resistant Bacteria: Focus on Machine Learning.Infection and drug resistance · 2026Review
- Research overview-2025: integrating scientific progress to accelerate global tuberculosis elimination.Frontiers in tuberculosis · 2026Article
- New drugs for the management of tuberculosis.Current opinion in infectious diseases · 2025Review
- Article
- Durable Antibacterial Performance of Au-Ag-Cu Thin Films Prepared by Magnetron Sputtering: Real-World Applications.Molecules (Basel, Switzerland) · 2025Article
- Clinical best practices for caring for people with expanded resistance to newer TB drugs.IJTLD open · 2025Review
Corrections and comments
- Erratum issued
Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBedaquiline (BDQ) resistance presents a critical challenge in the fight against tuberculosis (TB), particularly multidrug-resistant (MDR) strains. The emergence of resistance to BDQ, a key drug in treating MDR-TB, poses significant threats to TB treatment effectiveness.
methodsThe National Institute of Tuberculosis and Respiratory Diseases in Delhi and the Médecins Sans Frontières clinic in Mumbai provide BDQ, delamanid, and carbapenem-based regimens for patients with suspected or confirmed treatment failure. BDQ phenotypic drug-susceptibility testing (DST) was performed for all BDQ-exposed patients. Treatment regimens were individualized based on exposure history, comorbidities, drug interactions, prior adverse drug reactions, and DST results.
resultsOf 117 BDQ-exposed patients from December 2020-December 2022, 42 (36%) exhibited a BDQ-resistant strain. Median (IQR) age was 24 (22-32) years, with 63 (54%) females and 94% with pulmonary TB. Patients with a BDQ-resistant strain were older (median age: 27 vs 23 years; P = .04), more likely to have lung cavities (risk ratio [RR]: 1.8; 95%-CI: 1.1-3.1; P = .02), and be resistant to clofazimine (RR: 2.3; 95%-CI: 1.5-3.6; P = .001). Overall, 102 patients initiated treatment. Patients with BDQ-resistance had higher risk of unfavorable outcomes compared with BDQ-susceptible patients (RR:2.1; 95%-CI: 1.5-2.8; P < .001). Overall, 87% (33/38) of patients with BDQ-resistance experienced unfavorable treatment outcomes: 15 (40%) died, 15 (40%) had treatment failure, and 3 (8%) were lost-to-follow-up.
conclusionsThe study highlights a concerning rate of BDQ-resistance among previously treated patients, resulting in poor treatment outcomes. To prevent treatment failure, we recommend implementing BDQ-DST, developing affordable and accurate rapid tests for BDQ-resistance, and intensifying research and development efforts for newer TB drugs.
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