bedaquiline + delamanid

A combination of **bedaquiline** and **delamanid**, two oral small-molecule antimycobacterial drugs, is used as part of salvage or individualized regimens for multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis. **Bedaquiline** inhibits mycobacterial ATP synthase, thereby blocking energy generation in *Mycobacterium tuberculosis*. **Delamanid** is a prodrug activated by the mycobacterial F420 coenzyme system, where it inhibits synthesis of methoxy- and keto-mycolic acids, critical for the mycobacterial cell wall, and generates reactive nitrogen species. The combination is considered when therapy options are limited and there is extensive drug resistance, but carries an increased risk of QT interval prolongation. Large studies and limited clinical reports suggest this combination may be justified in select patients with careful cardiac monitoring[1][3].

Brand names

none specific for the combination

Other names

none known for the combination