Key takeaways
Sirturo (bedaquiline) and pyrazinamide are both antibiotics used to treat tuberculosis (TB), but they have some key differences. Sirturo (bedaquiline) is specifically for multi-drug resistant TB and is taken when other antibiotics don't work. It was approved under an accelerated process and is linked to a higher risk of death and heart problems. Pyrazinamide, on the other hand, is a first-choice medication for active TB and is usually taken with other TB antibiotics like isoniazid and rifampin. Unlike Sirturo, pyrazinamide is available as a lower-cost generic. Sirturo must be taken with at least three other anti-TB medications, while pyrazinamide is part of a standard four-drug regimen. Both medications can cause liver damage, but pyrazinamide can also raise uric acid levels, leading to gout. Sirturo is not available as a generic and is very expensive, whereas pyrazinamide is more affordable.
