Treatment Strategy for Rifampin-Susceptible Tuberculosis

   This randomized, open-label, noninferiority trial evaluates whether a treatment strategy using an initial 8-week regimen can achieve clinical outcomes comparable to standard 6-month rifampin-based therapy for pulmonary tuberculosis. Among 674 participants with rifampin-susceptible TB, two strategy groups completed full enrollment: one received high-dose rifampin-linezolid and the other bedaquiline-linezolid, both with companion drugs. The bedaquiline-linezolid strategy met noninferiority criteria, showing similar clinical efficacy at week 96 while reducing treatment duration to 85 days. Safety profiles and adverse event rates were comparable across groups. The study supports shortened TB therapy frameworks incorporating potent initial regimens, follow-up monitoring, and targeted retreatment to optimize outcomes and program efficiency.

   This randomized, open-label, noninferiority trial evaluates whether a treatment strategy using an initial 8-week regimen can achieve clinical outcomes comparable to standard 6-month rifampin-based therapy for pulmonary tuberculosis. Among 674 participants with rifampin-susceptible TB, two strategy groups completed full enrollment: one received high-dose rifampin-linezolid and the other bedaquiline-linezolid, both with companion drugs. The bedaquiline-linezolid strategy met noninferiority criteria, showing similar clinical efficacy at week 96 while reducing treatment duration to 85 days. Safety profiles and adverse event rates were comparable across groups. The study supports shortened TB therapy frameworks incorporating potent initial regimens, follow-up monitoring, and targeted retreatment to optimize outcomes and program efficiency.