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Received: 31 October 2021 DOI: 10.1111/bcp.Revised: 14 AprilAccepted: 27 AprilORIGINAL ARTICLEBedaquiline exposure in pregnancy and breastfeeding in females with rifampicin-resistant tuberculosisRichard Court1,|Kamunkhwala Gausi1 Helen McIlleron1,| |Buyisile Mkhize1 Gary Maartens1,|Lubbe Wiesner1 | Paolo Denti| |Catriona Waitt | Marian Loveday4,1 Division of Clinical Pharmacology, Division of Medicine, University of Cape TownAims: We aimed to explore the effect of pregnancy on bedaquiline pharmacokinetics (PK) and describe bedaquiline exposure in the breast milk of mothers treated for rifampicin-resistant tuberculosis (TB), exactly where there are no human information obtainable.Taurochenodeoxycholic acid Cancer Solutions: We performed a longitudinal PK study in pregnant females treated for rifampicin-resistant TB to explore the impact of pregnancy on bedaquiline exposure.PMID:23398362 Pharmacokinetic sampling was performed at 4 time-points over 6 hours in the third trimester, and once again at approximately six weeks postpartum. We obtained serial breast milk samples from breastfeeding mothers, in addition to a single plasma sample taken from breastfed and nonbreastfed infants to assess bedaquiline exposure. We made use of liquid chromatography andem mass spectrometry to carry out the breast milk and plasma bedaquiline assays, and population PK modelling to interpret the bedaquiline concentrations. Benefits: We recruited 13 females, 6 of whom completed the ante- and postpartum PK sampling. All participants have been HIV-positive on antiretroviral therapy. We observed decrease ante- and postpartum bedaquiline exposures than reported in nonpregnant controls. Bedaquiline concentrations in breast milk have been greater than maternal plasma (milk to maternal plasma rati.