Salfinger and Migliori [1] discussed some important issues of bedaquiline, the most promising drug for treating multidrug-resistant (MDR) tuberculosis (TB) in the early twenty-first century. I am afraid of some issues that could be detrimental to the future of TB control. Bedaquiline should be used with caution, bacause of some methodological flaws in a few of the published landmark studies. In one study, Diacon et al. [2], the authors, without doing drug-sensitivity testing on isoniazid and rifampicin (criteria of MDR-TB), firmly concluded the effectiveness of their new regimen on MDR-TB patients. By using a regimen containing bedaquiline for susceptible patients to the tested drug does not predict bedaquiline's effectiveness in MDR-TB patients, as the pharmacokinetics and probability of pharmacodynamic target attainment (area under the time curve minimum inhibitory concentration ratio) are likely to be altered in MDR patients [3]. We need a better drug to control drug resistant tuberculosis (MDR TB) http://ow.ly/MTcSu
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