2. • Drug-resistant TB remains challenging to cure; side effects and length of
treatment have continued to impact patients negatively.1,2 MDR TB incidents
are 3.3% of new TB cases and 18% of previously treated cases.3 Patients with
Chronic kidney disease (CKD) are associated with an increased risk of
infection.4–6 TB is the infection that present in CKD patients frequently.7-9
Tuberculosis patients with CKD have a worse prognosis and more diffi
3. • ult therapy.10,11 Pretomanid with bedaquiline and linezolid (BPaL)
administered to adults with a diagnosis of pulmonary extensively drug
resistant or treatment intolerant or nonresponsive MDR TB (TI/NR MDR TB).12
We present a case pre XDR lung TB with previous short treatment regiment
anti TB drug failure and CKD as a comorbide.
4. • A 53 years old woman referred from a regional hospital after her
short-term regiment DR TB drugs was failed. Chronic cough
was the patient chief complain for last one year and nausea
was often present. The patient also had a history of failed on first-line
tuberculosis treatment a year before DR-TB drugs treatment started. History
of diabetes melitus type 2 and CKD stage 4 were exist. GeneXpert MTB/RIF
assay perfom
5. • resistance reveals there were no resistancy in levoflocaxin, moxifloxacin,
kanamycin, amikacin and capreomycin. Growth-based drug susceptibility
testing performed and detected MTB with moxifloxacin resistancy. The patient
determined that her best treatment option was a 6-month all-oral regimen of
bedaquiline 400mg/200mg, pretomanid 200mg, and linezolid 1200mg (BPaL).
Cardiovascular, opthamology and pshychiatry tolerance recommend that there
were no contraindication to BPaL administration. Laboratorium testing showed
mild anemia and severe chronic kidney disease. The patient
6. received outpatient BPaL treatment 7 days a week by directly
observed therapy. We assessed liver, renal, hematologic, and QTc
intervals at baseline and every 2–4 weeks during treatment (Table 1).
Tabel 1. Haematology and QTc evaluation in BpaL treatment
