In MDR-TB regimens, what is a key component of all-oral therapy?

• A. Use of drugs like bedaquiline and linezolid in combination with others; monitor QT and marrow function
• B. Use of only injectable drugs
• C. Monotherapy with rifampin
• D. Shorter course therapy without bedaquiline

Answer: (A)

All-oral regimens for MDR-TB rely on a potent set of oral drugs, with bedaquiline and linezolid playing central roles, used together with other effective agents to build a regimens that avoids injectables and lowers resistance risk. Bedaquiline provides strong activity against resistant strains, while linezolid adds important bactericidal effect and helps prevent relapse when used with companions. Because these drugs carry notable safety concerns—bedaquiline can cause QT interval prolongation, and linezolid can cause bone marrow suppression—patients require careful monitoring, including baseline and periodic ECGs to watch the QT and regular blood counts to track marrow function. This combination and safety oversight are what make all-oral MDR-TB therapy feasible and effective, distinguishing it from regimens that rely on injectable drugs, monotherapy, or shorter courses without these agents.