Indian Journal of Forensic Medicine & Toxicology, January-March 2021, Vol. 15, No. 1 1783 Impact of Bedaquiline on Multidrug-Resistant Tuberculosis Treatment to Mother and Baby: An Incidental Case Tutik Kusmiati 1 , Faradila Nur Aini 2 1 Medical Staff, Infection Division, Departement of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, 2 Resident, Departement of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia Abstract Background: Bedaquiline is a new drug which is recommended by World Health Organization (WHO) for individual regiment drug resistant-tuberculosis (DR-TB). The presence of regiment DR-TB in the blood is long enough with T 1/2 5-6 months, that is why bedaquiline is given on six months. Bedaquiline is not recommended for pregnant women because there is no data related to safety. The author will report an incidental pregnant female on bedaquiline treatment. Case presentation: A 24-year-old woman with multidrug resistant tuberculosis (MDR TB) on individual regiment bedaquiline had incidental pregnancy at the 6 th month treatment. In the beginning, the patient used bedaquiline because of the intolerance of second-line injectable drug. Bedaquiline regiment was used for 24 th week. Pregnancy occured at the 6 th month treatment. The patient continued the pregnancy and the MDR TB treatment was continued without bedaquiline. Nausea and vomiting were getting worse. Preterm labour occured in 33/34 weeks by cesarean section. The baby had severe asphyxia, used continuous positive airway pressure (CPAP), treated in NICU, had low weight but there was no disability. After several days of treatment, the condition of baby was improving and was able to outpatient. Conclusion: The preterm labour, low birth weight, and neonatal emergency occured in a pregnant woman with MDR TB on individual regiment bedaquiline. Mother and baby can survive. More case and research data are needed on the safety of bedaquiline during pregnancy. Keywords: bedaquiline, multidrug resistant tuberculosis, pregnancy, mother, baby Introduction Treatment of multidrug resistant tuberculosis (MDR TB) is increasingly complicated when the patient is Corresponding outhor: Tutik Kusmiati Infection Division, Departement of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Jalan Mayjen Prof. Dr. Moetopo 6 – 8, Airlangga, Gubeng, Surabaya 60286, Indonesia Mail: tut.kusmiati@gmail.com Phone: +6231-5501656 ORCID ID: 0000-0002-5686-2377 pregnant. Pregnancy can occur when a patient has been diagnosed with MDR TB and is undergoing treatment or the pregnant woman diagnosed with MDR TB. There are still some controversial opinions regarding the management of MDR TB with pregnancy (1) . Some clinicians recommend terminating pregnancies and continuing MDR treatment. Other clinicians delay administration of the drug temporarily, especially in the early trimester. This doubt occurs because there is no data on the safety of MDR TB drugs in pregnant women and fetuses. Case Presentation A 24-year-old woman with MDR TB on individual regiment bedaquiline had incidental pregnancy at