Experiences in the introduction of bedaquiline pretomanid linezolid for drug-resistant tuberculosis in Kyrgyzstan.

ABSTRACT

Settings In Kyrgyzstan, drug-resistant tuberculosis poses a significant challenge. Recognizing the potential of the BPaL regimen, the World Health Organization recommended its use for selected drug-resistant TB cases under operational research conditions in 2020. Objective: This report presents experiences and results from the BPaL operational research under the LIFT-TB project in Kyrgyzstan. Design: Prospective cohort study. Results: From August 2021 to June 2022, 50 patients were enrolled, achieving an 84 % treatment success rate. Although adverse events affected 11 patients (34.3 %), primarily linked to linezolid use (39 [78 %] patients started on 1200 mg linezolid daily), no unexpected adverse events occurred, and management was appropriate. The operational research emphasized proper patient inclusion, highlighting the crucial roles of psychological counselling support and active drug safety monitoring. Conclusion: With insights gained, Kyrgyzstan is now nationwide implementing the BPaLM/BPaL regimens for a broader drug-resistant TB patient group. The experiences, successes, and lessons from the BPaL operational research, along with the programmatic introduction, offer valuable guidance for global drug-resistant TB control strategies. This initiative becomes a resource for countries with similar drug-resistant TB burdens, promoting a collaborative global approach to address drug-resistant TB challenges.