Abstract: Objective To retrospectively assess the efficacy of bedaquiline in combination with conventional anti-tuberculosis (TB) drugs in treating 21 adolescent patients with drug-resistant pulmonary tuberculosis. Provide a basis for the treatment of drug-resistant pulmonary tuberculosis in adolescents. Method A total of 21 adolescent patients under the age of 18 with drug-resistant pulmonary tuberculosis who were treated with the bedaquiline-containing regimen at Chongqing Public Health Medical Center between January 2021 and October 2023 were enrolled, including two patients with rifampicin-resistant tuberculosis (RR-TB), 11 patients with multidrug-resistant tuberculosis (MDR-TB), and 8 patient with pre-extensively drug-resistant tuberculosis (pre-XDR-TB). The effectiveness of treatment was evaluated by analyzing the resolution of clinical symptoms, sputum culture conversion rate, and improvement in lesion absorption 24 weeks after treatment, as well as by analyzing the occurrence of adverse drug reactions such as changes in the QTc interval on electrocardiograms to assess safety. Result One patient completed a 12-week course of bedaquiline-containing treatment, whereas 18 patients finished a 24-week course and two finished a 28-week course. with a clinical symptom relief rate of 100%. Sputum culture conversion was achieved at 24 weeks in 90.5% (19/21) of patients and at 36 weeks in 100% (21/21) of patients, with the fastest time being at the end of 4 weeks of treatment and the median time being 8 weeks. Chest CT scans showed significant improvement in 10 cases and effectiveness in 11 cases. The treatment success rate was 100%。Adverse drug reactions included two cases of QTc interval prolongation, ten cases of drug-induced liver injury, six cases of hyperuricemia, two cases of peripheral neuropathy, two cases of optic neuritis, two cases of gastrointestinal reactions, one case of myelosuppression (mild anemia), and one case of drug-induced dermatitis. The majority of adverse drug reactions were mild (90%). The prevalence of QTc prolongation was 9.52%. Conclusion In the treatment of drug-resistant pulmonary tuberculosis in adolescents with bedaquinoline-containing regimen, the clinical symptoms were improved quickly, the time of negative conversion was short, the foci were absorbed well, the treatment success rate was high, and the incidence of QTC interval was low, the rate of grade 3 or above adverse events was low and the safety was high.

Key words: Pulmonary tuberculosis, Antitubercular agents, Adolescents, Curative effect