Bedaquiline reloading strategies following interruptions during daily dosing
Once-daily bedaquiline therapy is a WHO-listed alternative to thrice-weekly dosing for rifampicin-resistant tuberculosis, but, contrary to the thrice-weekly schedule, no guidance exists for treatment re-initiation after interruption. Using a population pharmacokinetic model, we simulated bedaquiline and M2 exposure under various interruption and reloading scenarios. Reloading strategies tailored to interruption duration restored bedaquiline exposure without clinically relevant increases in M2 peak concentrations, providing practical guidance for safe and effective treatment resumption of once-daily bedaquiline therapy.
Authors
- Elin M. Svensson (ORCID: https://orcid.org/0000-0002-0093-6445)
- Simon E. Koele (ORCID: https://orcid.org/0000-0002-7011-667X)
- Stijn W. van Beek (ORCID: https://orcid.org/0000-0001-8020-1934)
- James C M Brust
- Gary Maartens
- Nienke Kikstra
Institutions
- Uppsala University (SE)
- Albert Einstein College of Medicine (US)
- Radboud University Nijmegen (NL)
- University of Cape Town (ZA)
- University Medical Center (US)
- Radboud University Medical Center (NL)
- Radboud Institute for Molecular Life Sciences (NL)
- Wellcome Centre for Infectious Diseases Research in Africa (ZA)
Publication Details
- Journal
- Antimicrobial Agents and Chemotherapy
- Published
- 2026-04-30
- DOI
- https://doi.org/10.1128/aac.00063-26
- Primary Topic
- Tuberculosis Research and Epidemiology
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Institutes of Health
- Einstein-Rockefeller-CUNY Center for AIDS Research, Albert Einstein College of Medicine
- Wellcome Centre for Infectious Diseases Research in Africa