CDC recommends the use of pretomanid in combination with bedaquiline and linezolid in the treatment of adults with pulmonary extensively drug-resistant, pre-extensively drug-resistant (i.e., resistant to isoniazid, rifampin, and at least one fluroquinolone or a second-line injectable) or treatment intolerant/nonresponsive multidrug-resistant TB disease when a safe and effective treatment regimen cannot otherwise be provided. Patients receiving BPaL must be monitored closely for adverse events, particularly peripheral and optic neuropathy, myelosuppression, and hepatotoxicity. Patients should be evaluated for signs and symptoms of TB disease during treatment as an indication of nonresponse to the regimen and assessment for acquired resistance. These guidelines will be updated as additional studies are published utilizing pretomanid in short course regimens for treatment of patients with multidrug-resistant TB.
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