title: First use of bedaquiline in a patient with XDR-TB in Singapore.
abstract: Drug-resistant tuberculosis (TB) continues to pose a threat to global control of TB: 3.5% of new and 20.5% of previously treated TB cases were estimated to have multidrug-resistant (MDR)-TB in 2013. Approximately 9% of patients with MDR-TB had extensively drug-resistant (XDR)-TB. A 30-year-old Vietnamese woman previously treated for TB in her home country presented with 5 months of cough and shortness of breath 1 year after migrating to Singapore. Xpert MTB/Rif testing showed rpoB gene mutation. Phenotypic drug susceptibility testing revealed XDR-TB. Second and third-line TB drugs were commenced. To strengthen the efficacy of her treatment regimen, the novel anti-TB drug bedaquiline was obtained for the patient on compassionate grounds. We report the first use in Singapore of bedaquiline for the treatment of XDR-TB.
authors.affiliation: TB Control Unit, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Angeline Poh-Gek
authors.initials: AP
authors.lastname: Chua
authors.affiliation: Department of Pharmacy, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Grace Si-Ru
authors.initials: GS
authors.lastname: Hoo
authors.affiliation: Department of Respiratory Medicine, TB Control Unit, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Cynthia Bin-Eng
authors.initials: CB
authors.lastname: Chee
authors.affiliation: Department of Respiratory Medicine, TB Control Unit, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Yee Tang
authors.initials: YT
authors.lastname: Wang
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D064687:Diarylquinolines / Q000627:therapeutic use*; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000235:genetics; D013902:Radiography, Thoracic; D012846:Singapore; D014057:Tomography, X-Ray Computed
chemical_list: D000995:Antitubercular Agents; D064687:Diarylquinolines; C493870:bedaquiline