[Comment] A rifamycin-free regimen for shortened tuberculosis treatment

Shortening treatment for drug-susceptible pulmonary tuberculosis remains a significant goal in medicine. Previous research indicated that a 4-month rifapentine-based regimen demonstrated non-inferior efficacy compared to the standard 6-month treatment. In the current issue of The Lancet Infectious Diseases, Rodney Dawson and colleagues investigate whether treatment shortening can also be achieved without rifamycins. They propose an all-oral combination of quabodepistat, delamanid, and bedaquiline (DBQ). A rifamycin-free approach could offer considerable clinical value. It provides an alternative for situations where rifamycin-based strategies are constrained. These constraints may include drug-drug interactions, intolerance, or concerns regarding future resistance.