Bedaquiline is a new anti-TB drug used for MDR-TB. Its mechanism of action is unique because it targets:

• A Mycobacterial ATP synthase (subunit c of the F0 component), inhibiting oxidative phosphorylation ✓
• B Enoyl-ACP reductase (InhA) of mycobacterial fatty acid synthesis II
• C DprE1 enzyme involved in decaprenyl-phospho-D-ribose oxidase step in arabinogalactan synthesis
• D RNA polymerase beta-subunit (rpoB), preventing mRNA transcription

Explanation

Bedaquiline is a diarylquinoline that specifically inhibits the c-subunit of mycobacterial ATP synthase (atpE), uncoupling the proton pump from ATP synthesis and depleting mycobacterial energy. It is active against both replicating and non-replicating (dormant) mycobacteria, making it valuable in MDR and XDR-TB regimens. InhA is the target of isoniazid (option B); DprE1 is targeted by BTZ043 and macozinone (option C); rpoB is the rifampicin target (option D).

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.