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BPaL/BPaLM regimens for treatment of rifampin-resistant tuberculosis (TB) disease in patients ≥14 years of age

BPaL/BPaLM regimens for treatment of rifampin-resistant tuberculosis (TB) disease in patients ≥14 years of age
Regimen for treatment of rifampin-resistant, fluoroquinolone-resistant TB: BPaL regimen*
Bedaquiline 400 mg once daily for two weeks, then 200 mg three times weekly for subsequent 24 weeks
Pretomanid 200 mg once daily for 26 weeks
Linezolid 600 mg once daily for 26 weeks
Regimen for treatment of rifampin-resistant, fluoroquinolone-susceptible TB: BPaLM regimen
Bedaquiline 400 mg once daily for two weeks, then 200 mg three times weekly for subsequent 24 weeks
Pretomanid 200 mg once daily for 26 weeks
Linezolid 600 mg once daily for 26 weeks
Moxifloxacin 400 mg once daily for 26 weeks

BPaL: bedaquiline, pretomanid, and linezolid; BPaLM: bedaquiline, pretomanid, linezolid, and moxifloxacin.

* Medications should be administered seven days per week orally with food, with directly observed therapy for five of seven days per week.

¶ Medications should be administered seven days per week orally with food (avoiding milk, antacids, or other cationic items), with directly observed therapy for five of seven days per week.

Adapted with permission of the American Thoracic Society. Copyright © 2025 American Thoracic Society. All rights reserved. Saukkonen JJ, Duarte R, Munsiff SS, et al. Updates on the treatment of drug-susceptible and drug-resistant tuberculosis: An official ATS/CDC/ERS/IDSA clinical practice guideline. Am J Respir Crit Care Med 2025; 211:15-33. The American Journal of Respiratory and Critical Care Medicine is an official journal of the American Thoracic Society. Readers are encouraged to read the entire article for the correct context at https://www.atsjournals.org/doi/10.1164/rccm.202410-2096ST. The authors, editors, and The American Thoracic Society are not responsible for errors or omissions in adaptations.
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