Dear Editor,
We read with interest the article ‘Treatment out- comes and safety of bedaquiline, delamanid, and line- zolid in multidrug-resistant TB’.1 Here we report on our experience using bedaquiline (BDQ) to treat Mycobacterium abscessus (MAB). MAB exhibits extensive resistance patterns and treatment requires individualised regimens based on antimicrobial suscep- tibility testing (AST), coupled with clinical expertise.2 Current treatment options are limited, particularly for macrolide-resistant MAB, due to the expression of an inducible 23S rRNA methyltransferase erm(41) gene.2 The use of injectable agents such as amikacin, tigecy- cline or imipenem may be problematic due to logistic issues and the high incidence of adverse effects.3 BDQ is a diarylquinoline that acts through the inhibition of mycobacterial F1F0- adenosine triphosphate synthase, with an effective half-life of more than 5 months, is characterised by excellent intracellular mycobacterici- dal activity both on replicating and non-replicating strains of Mycobacterium tuberculosis. BDQ also dis- plays impressive in vitro activity against a broad range of non-tuberculous mycobacterial (NTM),4 but clinical data on the efficacy in MAB pulmonary disease (MAB- PD) are lacking.

[…] Link alla pubblicazione completa: Bedaquiline-based all-oral regimen for macrolide-resistant Mycobacterium abscessus pulmonary disease