A treatment regimen lasting 6–9 months, composed of bedaquiline, pretomanid and linezolid (BPaL), may be used under operational research conditions in multidrug-resistant tuberculosis (MDR-TB) patients with TB that is resistant to fluoroquinolones, who have either had no previous exposure to bedaquiline and linezolid or have been exposed for no more than 2 weeks.

In MDR/RR-TB patients on longer regimens containing amikacin or streptomycin, an intensive
phase of 6–7 months is suggested for most patients; the duration may be modified according
to the patient’s response to therapy.

In patients with confirmed rifampicin-susceptible, isoniazid-resistant tuberculosis, it is not recommended to add streptomycin or other injectable agents to the treatment regimen.

In MDR/RR-TB patients on longer regimens, a treatment duration of 15–17 months after culture
conversion is suggested for most patients; the duration may be modified according to the patient’s
response to therapy.

In MDR/RR-TB patients on longer regimens, a total treatment duration of 18–20 months is
suggested for most patients; the duration may be modified according to the patient’s response
to therapy.

Clavulanic acid should not be included in the treatment of MDR/RR-TB patients on longer
regimens.

P-aminosalicylic acid may be included in the treatment of MDR/RR-TB patients on longer
regimens only if bedaquiline, linezolid, clofazimine or delamanid are not used or if better options
to compose a regimen are not possible.

Ethionamide or prothionamide may be included in the treatment of MDR/RR-TB patients on
longer regimens only if bedaquiline, linezolid, clofazimine or delamanid are not used or if better
options to compose a regimen are not possible.

Imipenem–cilastatin or meropenem may be included in the treatment of MDR/RR-TB patients
on longer regimens.

Pyrazinamide may be included in the treatment of MDR/RR-TB patients on longer regimens.