{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T11:05:40Z","timestamp":1779275140078,"version":"3.51.4"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T00:00:00Z","timestamp":1778112000000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The regimen bedaquiline, pretomanid, and linezolid (BPaL), with or without moxifloxacin, is recommended for treating multidrug-resistant tuberculosis (MDR TB). We describe real-world outcomes and tolerability of BPaL, with or without fluroquinolone (BPaL-FQ) in the U.S.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data collected by the California MDR TB Service for patients receiving BPaL and BPaL-FQ during 2020\u20132024, we analyzed favorable outcomes (cure or treatment completion), relapse, and adverse event frequency and severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety-seven patients were started on any pretomanid-containing regimen during 2020\u20132024; 76 (78%) of these had pulmonary TB, 21 (22%) had concurrent or exclusive extrapulmonary disease. Sixty-nine patients received at least 4 weeks of BPaL or BPaL-FQ and had final outcome documented. Favorable treatment outcomes were reported in 64 (93%) patients overall and in more than 80% of patients in almost all subgroups, regardless of underlying resistance pattern, site of disease, or comorbidities. There were no microbiologically confirmed TB relapses. Two deaths occurred in patients receiving BPaL-FQ. Adverse events that led to a drug change occurred in 40% of patients and included peripheral neuropathy, cytopenias, gastrointestinal upset, and headache or dizziness. The majority were attributed to linezolid 600 mg daily and associated with linezolid trough above 2 \u00b5g\/mL; fluroquinolones were also frequently implicated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In a cohort of patients receiving BPaL or BPaL-FQ in California during 2020\u20132024, a majority had a favorable outcome. More than one third of patients required drug dosage change or discontinuation to complete therapy. Linezolid was the main driver of poor tolerability and regimen changes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag220","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T11:40:49Z","timestamp":1778067649000},"source":"Crossref","is-referenced-by-count":0,"title":["Outcomes and Treatment-limiting Adverse Events of Patients Receiving BPaL and BPaL-FQ in California"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6013-9886","authenticated-orcid":false,"given":"Shereen S","family":"Katrak","sequence":"first","affiliation":[{"name":"Tuberculosis Control Branch, California Department of Public Health , Richmond, California ,","place":["USA"]},{"name":"Division of Infectious Diseases, School of Medicine, University of California , San Francisco, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9148-8778","authenticated-orcid":false,"given":"Rebecca C","family":"Wang","sequence":"additional","affiliation":[{"name":"Tuberculosis Control Branch, California Department of Public Health , Richmond, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8583-8326","authenticated-orcid":false,"given":"Chris E","family":"Keh","sequence":"additional","affiliation":[{"name":"Tuberculosis Control Branch, California Department of Public Health , Richmond, California ,","place":["USA"]},{"name":"Division of Infectious Diseases, School of Medicine, University of California , San Francisco, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0170-5649","authenticated-orcid":false,"given":"Scott 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A","family":"Wendorf","sequence":"additional","affiliation":[{"name":"Tuberculosis Control Branch, California Department of Public Health , Richmond, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rocio","family":"Agraz-Lara","sequence":"additional","affiliation":[{"name":"TB Prevention and Control Program , San Francisco Department of Public Health, San Francisco, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2671-2853","authenticated-orcid":false,"given":"Melony","family":"Chakrabarty","sequence":"additional","affiliation":[{"name":"Chest Clinic, Sacramento County Public Health , Sacramento, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1741-3648","authenticated-orcid":false,"given":"Jennifer R","family":"Chevinsky","sequence":"additional","affiliation":[{"name":"Riverside University Health System, Riverside County Department of Public Health , Riverside, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit S","family":"Chitnis","sequence":"additional","affiliation":[{"name":"Alameda County Public Health Department Tuberculosis Section, Division of Communicable Disease Control and Prevention, , San Leandro, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shom","family":"Dasgupta-Tsinikas","sequence":"additional","affiliation":[{"name":"Los Angeles County Department of Public Health Tuberculosis Control Program, , Inglewood, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Gooz\u00e9","sequence":"additional","affiliation":[{"name":"Tuberculosis Control Program, San Mateo County Public Health Department , San Mateo, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ankita","family":"Kadakia","sequence":"additional","affiliation":[{"name":"Tuberculosis Prevention and Care Branch, Public Health Services, County of San Diego Health and Human Services Agency , San Diego, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6903-4792","authenticated-orcid":false,"given":"Cameron","family":"Kaiser","sequence":"additional","affiliation":[{"name":"Solano County Department of Public Health , Fairfield, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janice K","family":"Louie","sequence":"additional","affiliation":[{"name":"TB Prevention and Control Program , San Francisco Department of Public Health, San Francisco, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Morgan","sequence":"additional","affiliation":[{"name":"Solano County Department of Public Health , Fairfield, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tuan Dung","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Tuberculosis Prevention and Care Branch, Public Health Services, County of San Diego Health and Human Services Agency , San Diego, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Percak","sequence":"additional","affiliation":[{"name":"Tuberculosis Prevention and Care Branch, Public Health Services, County of San Diego Health and Human Services Agency , San Diego, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea H","family":"Polesky","sequence":"additional","affiliation":[{"name":"Tuberculosis 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,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Sherrick","sequence":"additional","affiliation":[{"name":"County of Santa Barbara Public Health, Communicable Disease Control and Prevention Division , Santa Maria, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeanne D","family":"Soukup","sequence":"additional","affiliation":[{"name":"Los Angeles County Department of Public Health Tuberculosis Control Program, , Inglewood, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Che","family":"Waterman","sequence":"additional","affiliation":[{"name":"Tuberculosis Control Program, San Mateo County Public Health Department , San Mateo, California ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Preethi","family":"Yeturu","sequence":"additional","affiliation":[{"name":"Santa Clara Valley Healthcare, County of Santa Clara 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