Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 23, Number 10—October 2017

Bedaquiline and Delamanid Combination Treatment of 5 Patients with Pulmonary Extensively Drug-Resistant Tuberculosis

Andrey Maryandyshev1, Emanuele Pontali1, Simon Tiberi1, Onno Akkerman1, Shashank Ganatra1, Tsetan Dorji Sadutshang1, Jan-Willem Alffenaar1, Rohit Amale, Jai Mullerpattan, Sonam Topgyal, Zarir Farokh Udwadia, Rosella Centis1, Lia D’Ambrosio1, Giovanni Sotgiu1, and Giovanni Battista MiglioriComments to Author 
Author affiliations: Northern State Medical University, Arkhangelsk, Russia (A. Maryandyshev); Galliera Hospital, Genoa, Italy (E. Pontali); Royal London Hospital of Barts Health National Health Service Trust, London, UK (S. Tiberi); Queen Mary University of London, London (S. Tiberi); University of Groningen, Haren, the Netherlands (O. Akkerman, J.-W. Alffenaar); P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, India (S. Ganatra, R. Amale, J. Mullerpattan, Z.F. Udwadia); Delek Hospital, Dharamshala, India (T.D. Sadutshang, S. Topgyal); Maugeri Care and Research Institute, Tradate, Italy (R. Centis, L. D’Ambrosio, G.B. Migliori); Public Health Consulting Group, Lugano, Switzerland (L. D’Ambrosio); University of Sassari, Sassari, Italy (G. Sotgiu)

Main Article

Table 2

Summary of patients treated with bedaquiline and delamanid, including data on the anti-TB regimen administered, bacteriological conversion, treatment outcomes, and QT interval monitoring*

Pt no. Last TB drug regimen administered Sputum smear/culture conversion, d (treatment outcome) Dlm/Bdq exposure, d QT before treatment, ms QT average, ms (±SD) QT max, ms (wk)
1 Cm, Mfx, Eto, Cs, PAS, Cfz, Mpm, Lfx, Amx/Clv, Lzd, Bdq, Dlm NA/NA (failure; 4 mo after completing Bdq + Dlm treatment course, patient died because of respiratory insufficiency) 168/168 410 426 (±17.6) 450 (9)
2 Hd H, Cfz, Cs, E, Lzd, Dlm, Bdq; as of April 28, 2017, receving: Hd H, Cs, Cfz, cotrimoxazole 60/60 (continued treatment) 168/168 400 406 (±33.6) 462 (24)
3 Cm, Mfx, Bdq, Dlm, Lzd, Imp, Amx/Clv 435/104 (cured) 180/180 340 363 (±25.8) 400 (35 and 51)
4 Bdq, Dlm, Lzd, Cfz 30/30 (continued treatment) 155/155 394 462 (±39.8) 509 (5 and 9)
5 Dlm, Bdq, Cfz, Trd, Mpm, Amx/Clv 18/28 (continued treatment) 427/427 449 504 (±6.3) 520 (16)†

*Amk, amikacin; Amx/Clv, amoxicillin/clavulanate; Bdq, bedaquiline; Cfz, clofazimine; Cm, capreomycin; Cs, cycloserine; Dlm, delamanid; E, ethambutol; Eto, ethionamide; H, isoniazid; Hd, high dose; Imp, imipenem; Lfx, levofloxacin; Lzd, linezolid; max, maximum; Mfx, moxifloxacin; Mpm, meropenem; NA, not achieved; PAS, para-aminosalicylic acid; Pto, prothionamide; Pt, patient; QT, measure of the time between the start of the Q wave and the end of the T wave in the heart's electrical cycle; SD, standard deviation; TB, tuberculosis; Trd, terizidone.
†At different time points, intermittent episodes of asymptomatic QTc prolongation occurred.

Main Article

1These authors contributed equally to this article.

Page created: September 18, 2017
Page updated: September 18, 2017
Page reviewed: September 18, 2017
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.