Table 1 Anti TB drugs under evaluation in MDR/XDR clinical trials

Bedaquiline (Sirturo®; TMC207)

Diarylquinoline, blocking ATP synthetase, adaptive Licensing FDA: marketing approval for MDR end 2012. WHO interim recommendation by June 2013. By 2014, 43 countries had used, serious concern about QT-Prolongation [14]

Delamanid (OPC 67683)

Nitroimidazooxazole, Phase 2 results promising, Phase 3 ongoing (MDR). European Medicines Agency Committee for Medicinal Products for Human Use recommended licensing in Nov 2013. Safety: QT-Prolongation, WHO recommendation: Oct 2014 [15]

Fluoroquinolones: Moxifloxacin, Gatifloxacin

Class of broad-spectrum antibiotics that inhibit the DNA gyrase enzyme, effective in treating MDR-TB. Excellent early bactericidal activity, Lack sterilizing activity. Safety: QT prolongation, safety in combination therapy need further evaluation. Resistance and cross-resistance are reported and pose a threat. The optimal dose of Moxifloxacin and Levofloxacin – has not yet been ascertained. [16]

Pretomanid (PA-824)

Nitroimidazole, significant bactericidal and sterilizing activity alone and in combination tested in multiple MDR-TB regimens including the NC005, STAND and Nix-TB studies by TB Alliance MDR-TB treatment trial by MSF, the TB-PRACTECAL study, [16]

Clofazimine (CFZ)

Approved for leprosy treatment and used off-label for MDR-TB, tested in several MDR-TB regimens designed to shorten treatment Including the STREAM, TB PRACTECAL and end TB trials. Further studies underway [16]