Abstract

K. Sravani*, S. Aisha, R. Harsha Sree, G. Imran, J. Vanitha and Dr. K. Thirumala Naik

ABSTRACT

Multidrug-resistant tuberculosis (MDR-TB) continues to pose a significant global health threat, especially in high-burden countries like India. MDR-TB is caused by strains of Mycobacterium tuberculosis resistant to at least isoniazid and rifampicin, requiring more complex and prolonged treatment regimens. Conventional treatments for MDR-TB are lengthy and often associated with severe side effects. In response, newer therapeutic strategies such as the BPaL (bedaquiline, pretomanid, linezolid) and BPaLM (BPaL with moxifloxacin) regimens have emerged as promising alternatives. These all-oral regimens, endorsed by the WHO in 2022, offer significant advantages, including a shortened treatment duration of six months, improved efficacy, and fewer adverse effects compared to the traditional 9–11 months of therapy. The combination of bedaquiline, pretomanid, linezolid, and moxifloxacin targets multiple bacterial mechanisms, enhancing the effectiveness of the treatment. These regimens not only reduce treatment time but also lower healthcare costs, improve patient adherence, and contribute to a better quality of life. This paper reviews the epidemiology, pathogenesis, clinical presentation, diagnostic methods, and management of MDR-TB, emphasizing the novel BPaL/BPaLM regimens. These treatments represent a critical advancement in the fight against MDR-TB, offering improved accessibility, cost-effectiveness, and superior treatment outcomes, which are essential for the global elimination of drug-resistant tuberculosis.