<prompt> Which of the following is a new drug available to treat multi drug resistant tuberculosis?BedaquilineRifampicinLinezolidCefepime  <response>: Ans. a. Bedaquiline Ref: Harrison 19e p1115. 205e- 7Two novel drugs belonging to two new antibiotic classes--the diarylquinoline bedaquiline and the nitroimidazole delamanid--have recently been approved for use in severe cases of MDR-TB by stringent regulatory authorities.Two novel drugs belonging to two new antibiotic classes--the diarylquinoline bedaquiline and the nitroimidazole delamanid--have recently been approved for use in severe cases of MDR-TB by stringent regulatory authorities the L .S. Food and Drug Administration FDA and the European Medicine Agency EMA in the case of bedaquiline; the EM A and the Pharmaceuticals and Medical Devices Agency of Japan in the case of delamanid. -- Harrison 19e p1115BedaquilineBedaquiline is a new diarylquinoline with a novel mechanism of action: inhibition of the mycobacterial ATP synthetase proton pumpQ.It is bactericidal for drug-susceptible and MDR strains of M. tuberculosisQ.Mechanism of action:Inhibition of the mycobacterial ATP synthetase proton pump.Therapeutic Uses:Provisional recommendation for the use of bedaquiline for 24 weeks in adults with laboratory-confirmed pulmonary MDR-TB when no other effective treatment regimen can be provided.Side-Effects:Arrhythmias induce long QT syndrome by blocking the hERG channelResistance:Resistance has been reported and is due to point mutations in the atpE gene encoding for subunit c of ATP synthetase.Anti-Tubercular DrugsFirst line WHO Group 1Second lineThird line EthambutolQ EMB or E IsoniazidQ INH or H PyrazinamideQ PZA or Z RifampicinQ RMP or R StreptomycinQ SM or S Second line drugs WHO groups 2, 3 4 are only used to treat disease that is resistant to first line therapy, i.e., for extensively drug-resistant tuberculosis XDR-TB or multidrug- resistant tuberculosis MDR-TB. Aminoglycosides WHO group 2: Amikacin, kanamycinQ Polypeptides WHO group 2: Capreomycin, viomycin, enviomycinQ Fluoroquinolones WHO group 3: Ciprofloxacin, levofloxacin, moxifloxacinQ Thioamides WHO group 4: Ethionamide, prothionamideQ CycloserineQ WHO group 4 TerizidoneQ WHO group 5 Third-line drugs WHO group 5 include drugs that may be useful, but have doubtful or unproven efficacy. RifabutinQ ClarithromycinQ LinezolidQ ThioacetazoneQ ThioridazineQ Arginine Vitamin D BedaquilineQ DeiamanidQ 