Bedaquiline: An Effective Anti-tuberculous Drug with Novel Mechanism of Action

Abstract

There were 480,000 new cases of multidrug-resistant tuberculosis (MDR-TB) and 100,000 new patients with rifampicin-resistant tuberculosis (RR-TB) in 2015. Mortality was common in Asia with 250,000 deaths in the same year.1 Treatment was successful in 52% of the MDR/RR-TB patients whereas 17% mortality and 9% treatment failure were reported. Extensively drug-resistant TB (XDR-TB) have acquired in 9.5% of MDR-TB cases with 117 countries have reported for XDR-TB in the world.1 Treatment success rate was only 26% in XDR-TB cases.1 Drug sensitive strains of TB need treatment duration of 6 months whereas MDR-TB and XDR-TB requires more than 20 months of treatment.2 The burden of MDR-TB is increasing in various regions of the world. In the last 40 years after rifampicin has been started to be used in 1970s, no new anti-tuberculous drug was introduced.2 The research for the development of new anti-tuberculous drugs is expensive and slow because the replication rate of tubercle bacilli takes time and the pharmaceutical manufacturers which are present in well-developed countries without TB burden have no much interest.2