Novel Antibiotics Offer Hope for Safer Treatment of Drug-Resistant Tuberculosis
New research reveals promising alternatives to existing tuberculosis treatments, potentially reducing debilitating side effects for patients requiring long-term therapy.
Two new antibiotics, sutezolid and delpazolid, are showing significant promise in the fight against drug-resistant tuberculosis (TB). The findings, published in two peer-reviewed articles in The Lancet Infectious Diseases, suggest these medications could offer a safer and more tolerable treatment option, particularly for patients facing extended courses of therapy.
The Challenge of Existing TB Treatments
In 2022, the World Health Organisation (WHO) recommended the BPaLM regimen – a combination of bedaquiline, pretomanid, and moxifloxacin including linezolid – as a standard six-month treatment for multidrug-resistant tuberculosis. While effective, linezolid is known for its toxicity, creating a critical need for alternatives. “Despite its effectiveness, linezolid is simply too toxic for many patients. We urgently need safer alternatives in this antibiotic class,” stated a senior researcher at the Institute of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich.
Sutezolid and Delpazolid: A New Approach
Sutezolid and delpazolid belong to a class of medicines called oxazolidinones. Recent Phase IIb clinical trials evaluated these antibiotics in combination with bedaquiline, delamanid, and moxifloxacin – the first trials to utilize this specific four-drug combination. The results indicate improved safety and tolerability compared to linezolid in patients with drug-sensitive pulmonary tuberculosis.
Specifically, sutezolid demonstrated strong antibacterial activity and was well-tolerated across all tested doses. Delpazolid, on the other hand, enhanced the effectiveness of the combination therapy. A once-daily 1200mg dose of delpazolid achieved optimal drug levels for maximum efficacy and was well-tolerated over a 16-week period, according to the research team.
Promising Results from Clinical Trials
“These findings suggest that [sutezolid and delpazolid] may offer safer treatment options for [tuberculosis] patients, particularly those requiring longer courses of therapy,” explained Dr. Tina Minja, National PI for the DECODE study at NIMR-Mbeya Medical Research Centre in Tanzania.
The research team observed fewer side effects with both sutezolid and delpazolid, a significant step toward more patient-friendly TB therapies. “Seeing fewer side effects with sutezolid and delpazolid is a significant step forward—it brings us closer to [tuberculosis] therapies that are both effective and easier for patients to tolerate,” commented Dr. Ivan Norena, Medical Team Lead at the Institute of Infectious Diseases and Tropical Medicine at LMU University Hospital Munich.
Future Directions and Potential Impact
Researchers plan to evaluate sutezolid and delpazolid in larger patient cohorts. If further development proves successful, these antibiotics could become key components of next-generation treatments for drug-resistant tuberculosis, reducing treatment-related side effects while maintaining efficacy. This advancement could significantly improve the quality of life for individuals battling this challenging disease.
