bedaquiline + clarithromycin + ethambutol

A three-drug **oral combination regimen** of bedaquiline, clarithromycin, and ethambutol, primarily studied for the treatment of **treatment-refractory Mycobacterium avium complex-lung disease (MAC-LD)**. - **Bedaquiline** is a diarylquinoline antimycobacterial that inhibits the mycobacterial ATP synthase. - **Clarithromycin** is a macrolide antibiotic that inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit. - **Ethambutol** is a bacteriostatic antimycobacterial that inhibits arabinosyl transferases, affecting cell wall synthesis. This specific combination has been evaluated for efficacy and safety in MAC-LD, particularly in patients not responding to standard first-line therapies. The regimen is supported by mechanistic rationale for combining agents with independent actions on mycobacteria, aiming to enhance efficacy and minimize resistance.