On the face of it, the pipeline for tuberculosis drugs seems to be in fi ne shape. In little more than a year the armamentarium for treatment of multidrug-resistant tuberculosis has grown by two. Bedaquiline gained approval from the US Food and Drug Administration (FDA) in December, 2012, the first novel tuberculosis drug to do so in more than 40 years (panel). And in November, 2013, the Europe...

M ycobacterium tuberculosis, the causative agent of tuberculosis (TB) has only one hostus. Specimens of our earliest known upright ancestors, Homo erectus, from more than 500,000 years ago show pathology consistent with TB disease, and whole genome sequences of TB strains have been constructed from the remains of Peruvian mummies that were over 1000 years old. Despite our long and intimate rel...

The new medicinal compound bedaquiline (BDQ) kills Mycobacterium tuberculosis by inhibiting F1Fo-ATP synthase. BDQ is bacteriostatic for 4 to 7 days and kills relatively slowly compared to other frontline tuberculosis (TB) drugs. Here we show that killing with BDQ can be improved significantly by inhibiting cytochrome bd oxidase, a non-proton-pumping terminal oxidase. BDQ was instantly bacteric...

Two new drugs-bedaquiline and delamanid-have recently been approved by stringent regulatory authorities to treat multidrug-resistant tuberculosis (TB) and recommended by the World Health Organization for use under defined programmatic conditions. Introducing the medications in TB programs worldwide has not kept pace with the need for these drugs. In response, the DR-TB STAT (Drug-Resistant TB S...

MmpL5 in Mycobacterium tuberculosis. Antimicrob Agents Chemother 2014; 58: 2979–2981. 9 Milano A, Pasca MR, Provvedi R, et al. Azole resistance in Mycobacterium tuberculosis is mediated by the MmpS5–MmpL5 efflux system. Tuberculosis 2009; 89: 84–90. 10 Petrella S, Cambau E, Chauffour A, et al. Genetic basis for natural and acquired resistance to the diarylquinoline R207910 in mycobacteria. Anti...

The European Respiratory Journal has recently discussed delamanid and bedaquiline and their use in difficult-to-treat cases affected by multidrug-resistant tuberculosis (MDR-TB) or extensively drug-resistant (XDR-TB) [1–4]. The use of delamanid or bedaquiline is particularly important when four active drugs cannot be identified and included in a regimen, as per World Health Organization (WHO) g...

Bedaquiline (1) is a new drug for tuberculosis and the first of the diarylquinoline class. It demonstrates excellent efficacy against TB but induces phospholipidosis at high doses, has a long terminal elimination half-life (due to its high lipophilicity), and exhibits potent hERG channel inhibition, resulting in clinical QTc interval prolongation. A number of structural ring A analogues of beda...

tuberculosis prevention, care and control after 2015. Geneva, WHO, 2014. 13 World Health Organization. Definitions and reporting framework for tuberculosis – 2013 revision. Geneva, WHO, 2013. 14 Van Deun A, Maug AK, Bola V, et al. Rifampicin drug resistance tests for tuberculosis: challenging the gold standard. J Clin Microbiol 2013; 51: 2633–2640. 15 Salje H, Andrews JR, Deo S, et al. The impo...

Abstract Background Tuberculosis is an infection that has high mortality rate in human as well animals if it remains unattained for long time. Scientists are always desirous to discover new molecules against Mycobacterium tuberculosis ; one of them bedaquiline which was recently approved treat multidrug resistance TB. During the clinical study molecule stability and impurity key aspects develop...