Concurrent use of bedaquiline and delamanid for the treatment of fluoroquinolone-resistant multidrug-resistant tuberculosis: a nationwide cohort study in South Korea

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Multidrug-resistant tuberculosis (MDR-TB), a major global health concern, requires long-term treatment with multiple drugs, which can cause many side-effects [1]. Therefore, an effective regimen with a minimum number of drugs is essential to control this disease. Bedaquiline (Bdq) and delamanid (Dlm) are new drugs that exhibit good efficacy and safety for MDR-TB treatment [1]. However, adding only one of the new drugs to a regimen may be insufficient to cure this disease when the infecting strain has a high level of drug resistance, such as fluoroquinolone-resistant MDR-TB or extensively drug-resistant TB (XDR-TB) [1–3]. Therefore, the concurrent use of Bdq and Dlm can effectively strengthen the treatment regimen if the best practices in “off-label” use are followed [4–10]. This study analysed the efficacy and safety of concurrent use of Bdq and Dlm in patients with MDR-TB and XDR-TB treated under a programmatic condition.