First use of bedaquiline in a patient with XDR-TB in Singapore

Abstract

Drug-resistant tuberculosis (TB) continues to pose a threat to global control of TB: 3.5% of new and 20.5% of previously treated TB cases were estimated to have multidrug-resistant (MDR)-TB in 2013. Approximately 9% of patients with MDR-TB had extensively drug-resistant (XDR)-TB. A 30-year-old Vietnamese woman previously treated for TB in her home country presented with 5 months of cough and shortness of breath 1 year after migrating to Singapore. Xpert MTB/Rif testing showed rpoB gene mutation. Phenotypic drug susceptibility testing revealed XDR-TB. Second and third-line TB drugs were commenced. To strengthen the efficacy of her treatment regimen, the novel anti-TB drug bedaquiline was obtained for the patient on compassionate grounds. We report the first use in Singapore of bedaquiline for the treatment of XDR-TB.

Successful treatment of XDR-TB patient in Tanzania: report of the first XDR-TB patient

“…A similar experience was had in Singapore. 5 Bedaquiline appears to be associated with more rapid sputum conversion and higher cure rates than many other medications for drug-resistant TB. Similarly, good treatment outcomes were achieved in Kyrgyzstan and Mali.…”