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Updated: Jan 4, 2026
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An In Vitro Caseum Binding Assay that Predicts Drug Penetration in Tuberculosis Lesions
Published on: May 8, 2017
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Clinical Outcomes Among Patients With Drug-resistant Tuberculosis Receiving Bedaquiline- or Delamanid-Containing
R R Kempker1, L Mikiashvili2, Y Zhao3
1Department of Medicine, Division of Infectious Disease, Emory University School of Medicine, Atlanta, Georgia, USA.
Summary
Bedaquiline-based regimens showed better results than delamanid-based ones for multidrug-resistant tuberculosis (MDR-TB). Bedaquiline led to higher culture conversion and favorable outcomes with less acquired drug resistance.
Area of Science:
- Infectious Diseases
- Pulmonology
- Pharmacology
Background:
- Multidrug-resistant tuberculosis (MDR-TB) treatment options are limited.
- Bedaquiline and delamanid are new drugs for MDR-TB, but comparative data are scarce.
Purpose of the Study:
- To compare the effectiveness and safety of bedaquiline-based versus delamanid-based regimens for MDR-TB.
- To evaluate culture conversion rates and clinical outcomes in patients receiving these novel drug regimens.
Main Methods:
- Prospective, observational study in Georgia involving MDR-TB patients.
- Monthly sputum cultures, drug resistance testing, and adverse event monitoring.
- Targeted maximum likelihood estimation and super learning for covariate-adjusted outcome proportions.
Main Results:
- Bedaquiline-based regimens (n=64) and delamanid-based regimens (n=31) showed similar numbers of effective companion drugs.
- Significantly higher acquired drug resistance rates with delamanid (36%) vs. bedaquiline (10%).
- Higher adjusted rates of sputum culture conversion at 6 months (95% vs. 74%) and favorable clinical outcomes (96% vs. 72%) with bedaquiline.
Conclusions:
- Bedaquiline-based regimens are associated with superior outcomes in MDR-TB treatment compared to delamanid-based regimens.
- Bedaquiline demonstrated higher culture conversion rates, better clinical outcomes, and a lower incidence of acquired drug resistance.
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