Activity of bedaquiline against mycobacteria (review)

Resistance of M. tuberculosis to anti-tuberculosis drugs (ATDs) and then to antibacterial drugs initially developed for other purposes, but effective against M. tuberculosis is an extremely serious problem. Treatment of drug-resistant tuberculosis is difficult, it is significantly more expensive, and its effectiveness is lower than in the treatment of drug-sensitive tuberculosis. With the advent of new anti-TB drugs such as bedaquiline and delamanid, the efficacy of etiotropic chemotherapy for MDR- and XDR-TB has increased significantly. The review shows that bedaquiline has high activity in vitro against both M. tuberculosis and non-tuberculous mycobacteria. However, strains with natural resistance to this drug have been found in some cases. There are also data on the development of acquired resistance to bedaquiline. This indicates the need for rational (according to indications and in accordance with the developed optimal dosages and regimens) use of bedaquiline in the treatment of tuberculosis and mycobacterioses.