Child holding a dandelion with seeds turning into medicine capsules, symbolizing hope for treating drug-resistant diseases.

New Hope for Kids Fighting Superbugs: Delamanid & Bedaquiline

Nico Varela in Health & Wellness December 2025 • 4 min read.

"A review reveals the potential of delamanid and bedaquiline in treating drug-resistant tuberculosis in children, offering a beacon of hope in the fight against these challenging infections."

Tuberculosis (TB), especially in its drug-resistant forms, remains a major global health challenge, affecting millions, including children. Multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) require lengthy, expensive treatments with often suboptimal outcomes due to side effects and treatment failures.

The World Health Organization (WHO) has updated its guidelines for designing MDR-TB treatment regimens, incorporating new drugs like delamanid and bedaquiline. These drugs are typically reserved for adults under strict monitoring, but recent data has led to the recommendation of delamanid for children over 6 years old.

A systematic review was conducted to evaluate the efficacy, safety, and tolerability of delamanid and bedaquiline in children with confirmed MDR/XDR-TB, providing crucial insights for clinicians and families facing these difficult diagnoses.

Delamanid and Bedaquiline: Promising Options for Children with Drug-Resistant TB?

Child holding a dandelion with seeds turning into medicine capsules, symbolizing hope for treating drug-resistant diseases.

The study focused on finding scientific evidence regarding the use of delamanid or bedaquiline in children with MDR/XDR-TB. Researchers searched databases like PubMed and Embase for relevant articles published in English up to December 31, 2016.

The review included studies that assessed the effectiveness, safety, and how well children tolerated these medications. Studies were excluded if they were: experimental animal studies, reviews focused solely on adults, or cases that weren't bacteriologically confirmed. From the initial search, only three studies met the strict inclusion criteria, highlighting the limited data available.

Limited Evidence: The review found very few studies specifically addressing the use of delamanid and bedaquiline in children with drug-resistant TB.
Delamanid Shows Promise: The available studies, though limited, suggest that delamanid may be a valuable option for children with MDR/XDR-TB, particularly when other treatment options have been exhausted.
Bedaquiline Data Lacking: Unfortunately, no studies were found that specifically investigated the use of bedaquiline in children.

The studies that were reviewed primarily focused on the compassionate use of delamanid, where the drug was provided to patients with limited treatment options due to the severity of their condition. While results were promising, further controlled clinical trials are needed to confirm these findings and establish optimal treatment protocols. Several ongoing trials are investigating these new drugs in children.

The Future of Treating Drug-Resistant TB in Children

The review underscores the urgent need for more research on the use of new anti-TB drugs in children. While delamanid shows promise, the lack of data on bedaquiline highlights a significant gap in our knowledge.

Ongoing clinical trials are crucial to gathering the evidence needed to develop safe and effective treatment guidelines for children with MDR/XDR-TB. These trials will help determine optimal dosages, identify potential side effects, and assess long-term outcomes.

For families and healthcare providers, staying informed about the latest research and treatment options is essential. Consulting with TB specialists and participating in clinical trials can provide access to cutting-edge therapies and contribute to advancing our understanding of these challenging infections.

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This article is based on research published under:

DOI-LINK: 10.21037/jtd.2017.06.16, Alternate LINK

Title: Delamanid And Bedaquiline To Treat Multidrug-Resistant And Extensively Drug-Resistant Tuberculosis In Children: A Systematic Review

Subject: Pulmonary and Respiratory Medicine

Journal: Journal of Thoracic Disease

Publisher: AME Publishing Company

Authors: Lia D’Ambrosio, Rosella Centis, Simon Tiberi, Marina Tadolini, Margareth Dalcolmo, Adrian Rendon, Susanna Esposito, Giovanni Battista Migliori

Published: 2017-07-01

Everything You Need To Know

What is drug-resistant Tuberculosis (TB), and why is it a problem?

Drug-resistant Tuberculosis (TB) is a form of TB that does not respond to the standard medications used to treat the illness. Multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) are particularly concerning as they are difficult to treat, require long and expensive treatments, and often have less than ideal outcomes. This poses a significant health challenge, especially for children, as it limits their treatment options and increases the risk of serious complications.

What are delamanid and bedaquiline, and why are they important for children with TB?

Delamanid and bedaquiline are newer drugs used to treat drug-resistant TB, offering hope for children. Delamanid has shown promise in early studies, especially for children over six years old, as per World Health Organization (WHO) guidelines, and is typically used when other treatments have failed. The use of Bedaquiline in children is still under investigation, highlighting a key area where more research is needed. These medications are vital because they represent a potential advancement in the treatment of a disease that has proven difficult to cure with conventional methods.

What was the focus of the research review regarding delamanid and bedaquiline?

The review conducted focused on assessing the effectiveness, safety, and tolerability of delamanid and bedaquiline in children with drug-resistant TB. The research team specifically looked for scientific evidence of these drugs in this demographic. The research included studies that analyzed the efficacy, safety, and tolerability of these drugs. The review aimed to provide valuable information to clinicians and families dealing with this difficult diagnosis by consolidating the available data on the effectiveness of these drugs in children.

What did the review reveal about delamanid and bedaquiline in children?

The findings indicate that delamanid shows potential in treating children with MDR/XDR-TB, particularly when other treatments have been exhausted, as suggested by the available, albeit limited, studies. Conversely, the lack of data on bedaquiline suggests an urgent need for further research. These insights are significant because they help guide treatment decisions and highlight areas where more clinical trials are required to fully understand the benefits and risks of these drugs.

What are the next steps in using delamanid and bedaquiline to treat children with drug-resistant TB?

Further research is essential to determine the best way to use delamanid and bedaquiline in children with drug-resistant TB. More studies are needed to confirm delamanid’s effectiveness and safety through rigorous, controlled clinical trials and determine the role of bedaquiline in pediatric treatment regimens. The research underscores the critical need for comprehensive clinical trials to establish optimal treatment protocols, dosages, and long-term outcomes for these drugs, ensuring the best possible care for children affected by this challenging disease.