A review published in BMJ Open Respiratory Research in 2026 confirms that shorter all-oral treatment regimens for multidrug-resistant (MDR) and rifampin-resistant (RR) tuberculosis (TB) are as effective as older injectable-based regimens, with significantly fewer side effects. The study analyzed data from multiple clinical trials and observational studies, highlighting the shift toward bedaquiline- and delamanid-containing regimens.
The World Health Organization (WHO) has recommended all-oral regimens since 2020, but implementation has been uneven. The review emphasizes that these regimens reduce the need for daily injections, which often cause pain and hearing loss, and improve treatment completion rates. Key drugs include bedaquiline, pretomanid, and linezolid, often combined in a 6-month regimen.
According to the review, treatment success rates for all-oral regimens exceed 80% in many settings, comparable to or better than older regimens. However, challenges remain, including drug resistance to bedaquiline and the need for better monitoring of side effects like myelosuppression from linezolid. The authors call for expanded access to these regimens in low- and middle-income countries.
