Updates to Provisional Guidance for the Use of Pretomanid as Part of a Regimen [Bedaquiline, Pretomanid, and Linezolid (BPaL)] to Treat Drug-Resistant Tuberculosis Disease

Dear Colleague Letters

May 4, 2023

Dear Colleagues,

Today, CDC released updates to the 2022 "Provisional CDC Guidance for the Use of Pretomanid as part of a Regimen [Bedaquiline, Pretomanid, and Linezolid (BPaL)] to Treat Drug-Resistant Tuberculosis Disease."

Updates include:

• A recommendation for an initial linezolid dose of 600 mg when using the BPaL regimen in the treatment of adults,
• Additional information about adverse events, and
• References to studies that were published after the initial release of the guidance.

We encourage healthcare providers, pharmacists, and public health professionals to review the updated provisional guidance. When drug-resistant TB is suspected or confirmed, providers should consult a TB expert physician. Healthcare providers can contact state and local TB control offices and TB Centers of Excellence for Training, Education and Medical Consultation for additional information on diagnosing and treating drug-resistant TB disease.

CDC has additional information on drug-resistant TB disease for healthcare providers, public health professionals, and patients.

Thank you for your work and continued commitment to address the challenges of drug-resistant TB.

Sincerely,

Philip LoBue, MD, FACP, FCCP
Director
Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention