In general, TB medicines should be dosed according to body weight. Dosing of bedaquiline and delamanid for children and young adolescents aged under 15 years was updated in 2021 following an expert consultation meeting convened by WHO. These dosing recommendations are included in Annex 6 and may be updated as evidence emerges, especially for the youngest age groups, for which there is very limited evidence. Monthly monitoring of body weight is especially important in children and adolescents, with adjustment of doses as children gain weight. For dosing recommendations for
adolescents aged 15 years and over, see Annex 1 of the WHO operational handbook on tuberculosis. Module 4: treatment – drug-resistant tuberculosis treatment (82).

The bioavailability (absorption) of bedaquiline, delamanid and clofazimine are significantly improved when given with food, especially high-fat meals, and so they should be given with food whenever possible. Delamanid is recommended to be administered separately in time (ideally 1 hour) from other medicines, including TB and ART medicines, to avoid potential negative effects on delamanid absorption (121).

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