Tuberculosis (TB) disproportionately affects vulnerable populations including those with limited economic resources, HIV patients, those whose diet is deficient in nutrients and others.

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Source: CDC/ Antibiotic Resistance Coordination and Strategy Unit

Medical illustration of drug-resistant Mycobacterium tuberculosis bacteria

Resistant TB (MDR TB) does not respond to first line medications and is difficult to treat, requiring long regimens of 15-20 months that are associated with significant side effects and poor outcomes.

Recently, new six-month regimens have been shown to have better results than the long-term treatments, with improved quality of life and health equity. But these novel regimens have not yet been adopted widely in the United States.

Six-month regimen

In a study “Initial experience with BPaL based regimens for multidrug resistant tuberculosis treatment in Massachusetts”  published in the International Journal of Tuberculosis and Lung Disease, researchers from Boston University Chobanian & Avedisian School of Medicine document that four patients at Boston Medical Center (BMC) Tuberculosis Clinic were cured of MDR TB with a six-month regimen that included bedaquiline, pretomanid and linezolid (BPaL).

“Our study showed that MDR TB can be successfully treated with a six-month regimen that includes only pills. The shorter duration of therapy and the lesser pill burden will result in a better quality of life, improving health equity and access to therapy for MDR TB patients,” said corresponding author Carlos Acuna-Villaorduna, MD, an adjunct assistant professor of infectious diseases. “BMC is the first site in Massachusetts to use this novel treatment for patients with resistant TB.”

“The novel BPaL regimen is a major advance as it achieves superior outcomes with less side effects in a significantly shorter period of time,” said Acuna-Villaorduna, who cited the collaboration between TB clinicians, public health nurses, pharmacists, microbiologists and public health leaders that allowed BMC to safely implement this cutting-edge treatment.

This study appeared online in The International Journal of Tuberculosis and Lung Disease.