BPaL/BpaLM regimen: A bright future for drug–resistant tuberculosis

Indonesia is one of the countries with the highest burden of tuberculosis and drug-resistant tuberculosis (DR-TB) across the world. Based on data from the World Health Organization (WHO) Global TB Report 2023, it is estimated that there are 10 000 cases of DR-TB in Indonesia. Bedaquiline, a novel antitubercular drug, has been implemented to treat DR-TB globally. It was administered either a shorter (9 months) or individualized treatment regimen (18 months). However, long treatment duration with various adverse events affects patient compliance. Therefore, a short treatment with less medication is urgently required. In 2022, the WHO announced an alternative regimen-bedaquiline, pretomanid, linezolid, and moxifloxacin (BPaLM) to treat DR-TB patients for six months without resistance to fluoroquinolones[1]. This recommendation is based on previous clinical trials of TB, Zenix TB, and TB PRACTECAL. The introduction of BPaL and BPaLM provided a bright future for treating DR-TB patients.