Challenges of Using a Bedaquiline-Based Regimen to Treat Multidrug-Resistant Tuberculosis in Pregnancy

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ID: 331888
2026
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Abstract
Abstract The treatment of multidrug-resistant tuberculosis (MDR-TB) in pregnancy has been historically limited by the exclusion of pregnant and breastfeeding persons from large clinical studies. We follow the case of a pregnant patient successfully treated for MDR-TB in California, USA using a bedaquiline-based regimen and discuss the growing body of evidence and evolution of recommendations in the management of this patient population. We discuss obstacles in the patient’s care, including issues of regimen selection, question of breastfeeding, supratherapeutic drug levels postpartum, and medication adverse effects- all which should be considered in the management of pregnant persons. Based on our experience, we would recommend to consider monitoring drug levels during this transition to postpartum status. Further inclusion of pregnant and breastfeeding patients in MDR-TB studies will continue to bolster knowledge base and improve patient outcomes.
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openalex_W7221002994 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Adriana A. M. Giuliani, Kristen A. Wendorf, Jeffrey Percak, Annie N. Cowell
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Journal Open forum infectious diseases
Year 2026
DOI
10.1093/ofid/ofag661
URL
https://doi.org/10.1093/ofid/ofag661
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