Increasing incidence of MDR-TB, long duration of treatment and co-infection with 
HIV are the significant problems in achieving the eradication of tuberculosis. 
Bedaquiline is an anti-tuberculosis drug with unique mechanism of action. It 
selectively inhibits the mycobacterial energy metabolism i.e. ATP synthesis and 
found to be effective against all states of Mycobacterium tuberculosis like 
active, dormant, replicating, non-replicating, intracellular and extracellular. 
Preclinical studies have shown the efficacy of bedaquiline in terms of reduction 
in bacterial load and treatment duration. Phase II clinical studies have 
established the safety, tolerability and earlier sputum conversion time in 
patients with MDR-TB. In 2012 FDA approved bedaquiline for treatment of MDR-TB 
and XDR-TB.