Treatment outcome and adverse effects of new regimens (bedaquiline and linezolid) for multidrug-resistant tuberculosis during pregnancy: A systematic review

BackgroundManaging tuberculosis treatment during pregnancy, especially in women with multidrug-resistant tuberculosis (MDR-TB). The World Health Organization recommends a 9-month oral regimen that includes bedaquiline and linezolid, but the effects on pregnancy are not well understood.ObjectiveThis study aimed to assess the impact of a bedaquiline- and linezolid-containing regimen on maternal and fetal health in pregnant women with MDR-TB.MethodsA systematic review was conducted in accordance with the PRISMA guidelines, searching multiple databases for relevant studies published between 2004 and 2025. Study quality was assessed using the Joanna Briggs Institute (JBI) tool.ResultsFour studies were included. The regimen showed favorable treatment outcomes for mothers, with treatment success rates ranging from 60.7% to 98%. However, a high incidence of adverse pregnancy outcomes was reported, including preterm birth (28%-55%), low birth weight (32%-35%), and miscarriage or stillbirth. One study reported a 35% pregnancy termination rate.ConclusionWhile the bedaquiline and linezolid regimen appears highly effective against MDR-TB in mothers, it is associated with significant adverse fetal outcomes. Close monitoring and further research are essential to determine whether the drugs or the underlying MDR-TB disease causes these outcomes.