Abstract
The US Food and Drug Administration approved a 6-month regimen of pretomanid, bedaquiline, and linezolid for extensively drug-resistant or multidrug-intolerant tuberculosis after a trial in South Africa demonstrated 90% effectiveness 6 months posttreatment. We report on a patient who completed the regimen using a lower linezolid dose.
Highlights
The US Food and Drug Administration approved a 6-month regimen of pretomanid, bedaquiline, and linezolid for extensively drug-resistant or multidrug-intolerant tuberculosis after a trial in South Africa demonstrated 90% effectiveness 6 months posttreatment
Three sputum samples were negative by acid-fast bacilli (AFB) smear and culture; 1 was tested by PCR and was M. tuberculosis negative
Rapid molecular detection of drug resistance and growth-based drug susceptibility testing performed by the Centers for Disease Control and Prevention (CDC) and Florida Bureau of Public Health Laboratories yielded concordant results
Summary
Rapid molecular detection of drug resistance and growth-based drug susceptibility testing performed by the Centers for Disease Control and Prevention (CDC) and Florida Bureau of Public Health Laboratories yielded concordant results. Resistance was detected for pyrazinamide but not for ethambutol, bedaquiline, or linezolid The patient and her medical providers, in consultation with a CDCfunded TB Center of Excellence A bridging regimen of bedaquiline, linezolid, moxifloxacin, cycloserine, clofazimine, and ethambutol was initiated for 2 weeks, was narrowed to BPaL when pretomanid arrived. For this patient, we initiated linezolid at 600 mg/d, given the toxicity of the Nix-TB dose of 1,200 mg/d, the patient’s paucibacillary disease, and TB COE’s
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