On the Effectiveness of Bedaquiline in Chemotherapy Regimens for Drug-Resistant Tuberculosis in Children with Various Body Weights

Background. WHO experts emphasize that the use of bedaquiline in children is conditional, supported by limited evidence and a very low certainty of recommendations. The aim of the study was to evaluate the effectiveness of bedaquiline in chemotherapy regimens for drug-resistant tuberculosis in children depending on body weight. Methods. A retrospective study included 27 children (6–12 years) with confirmed or probable (reliable contact with a patient) MDR/pre-XDR tuberculosis. Group I included 11 children weighing  30 kg, Group II included 16 children weighing  30 kg. The bedaquiline dose was 200 mg daily for the first 2 weeks (saturation phase), then 100 mg 3 times a week for 22 weeks (maintenance phase). The following were assessed: the time to cessation of bacterial excretion and radiographic dynamics (closure of decay cavities; resorption of infiltrative, focal, and pleural changes). At the end of chemotherapy, the treatment outcomes were assessed; follow-up examinations were conducted after 6 months and after 1 year. Results. Within 3 months of chemotherapy, abacillation was achieved in all 3 patients with MBT. Lung cavity closure was achieved in 2 patients out of 4. Clinical cure was achieved in 100% of patients in the comparison groups (p  0.05). No recurrences were detected. Conclusion. This study, based on real-world clinical practice of using bedaquiline in children with tuberculosis aged 6–12 years, demonstrated the feasibility of effective use of the pediatric dosage of the drug in patients weighing 30 kg or more.

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