Which two newer anti-TB drugs are used for MDR-TB, and what safety monitoring is required?

• A. Bedaquiline and Delamanid; monitor QT interval via ECG
• B. Bedaquiline and Linezolid; monitor liver enzymes
• C. Delamanid and Ethambutol; monitor visual acuity
• D. Rifampin and Isoniazid; monitor CBC

Answer: (A)

Newer anti-TB drugs used for multidrug-resistant TB are bedaquiline and delamanid. They’re chosen for MDR-TB because they remain active against strains resistant to rifampin and isoniazid. A major safety concern with both drugs is QT interval prolongation, which can lead to potentially serious heart rhythm problems. Because of this, the essential safety monitoring is performing an ECG to measure the QT interval, ideally at baseline and during treatment, while also keeping an eye on electrolyte levels (potassium, magnesium) to minimize risk. The risk becomes higher if these drugs are used with other QT-prolonging medications, so ECG monitoring guides safe treatment.