Multidrug-resistant tuberculosis (MDR-TB) treatment is evolving. Last month the South Africa National Tuberculosis Program decided to prioritize oral bedaqualine for all rifampin-resistant TB (RR-TB) in place of — the often more toxic — injectable drugs. The question of whether a package of novel oral medications as part of a universal regimen can replace the current approach to TB management divides the TB therapeutic community. In this second article we further explore this divergence of opinion.

As tuberculosis (TB) is the world's most lethal infectious disease, there is an urgent need to improve the treatment of this bacterial infection. One approach under consideration is the institution of a universal or “pan-TB” regimen comprising new agents capable of treating multidrug-resistant (MDR) and even extensively drug-resistant (XDR) TB.