Bedaquiline is a diarylquinoline anti-tuberculosis drug. Bedaquiline affects the proton pump for ATP synthase. This mechanism is unlike that of the quinolones, whose target is DNA gyrase. Bedaquiline was described for the first time in 2004 at the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) meeting, after the drug had been in development for over seven years. One of the first published trials of Bedaquiline was a Phase II trial of 47 patients, which showed that the drug was effective in reducing the time to TB-free sputum cultures. A subsequent phase II efficacy trial was published in 2010 and sponsored by Tibotec and the TB Alliance. The most common side effects of bedaquiline in studies were nausea, joint and chest pain, and headache. The drug also has a black-box warning for arrhythmias, as it may induce long QT syndrome by blocking the hERG channel.
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