Good Outcomes in Babies With In Utero Bedaquiline Exposure

(See the Major Article by Loveday et al on pages 1158–68.) The paucity of data on the use of new tuberculosis (TB) drugs in pregnant women has been recognized as a major knowledge gap, and the exclusion of pregnant women from TB treatment trials as a major challenge [1, 2]. In this issue of Clinical Infectious Diseases, the report by Loveday and colleagues on maternal and infant outcomes among pregnant women treated for drug-resistant TB in South Africa presents valuable data on the safety of second-line TB drugs used in pregnancy [3]. It uniquely documents the outcome of 58 pregnant women treated with bedaquiline-containing regimens and 49 babies exposed to bedaquiline in utero. Pregnant women treated with bedaquiline, mostly as part of an all-oral regimen for drug-resistant TB, had more favorable outcomes (71% vs 62%) and less loss to follow-up (19% vs...