Patient description: Patient A is a 30-year-old male who was admitted to the hospital after 10 days of cough, profuse nocturnal sweating and loss of appetite. He had traveled to India 1 months ago and has not any positive history of TB vaccination. He is a previously healthy man, working as an engineer in a high tech company. He doesn't smoke o use any illicit drugs. He was febrile (38 c) with heart rate of 115 b/min, respiratory rate of 22, BP of 125/75 mmHg and O2 sat of 97%. Chest X-ray showed infiltrate in the middle of left lung with diameter of 1.8 cm with signs of cavitation. The sputum smear revealed positive sputum culture for Mycobacterium tuberculosis which are sensitive of the first-line TB drugs (isoniazid, streptomycin, rifampicin and ethambutol). Lab study is reported bellow: Hgb: 13 g/dl WBC: 14000 /mm3 Plt: 300000 /ml AST: 13 U/L ALT: 15 U/L Alk P: 53 U/L Bill total: 0.6 mg/dl Na: 137 mEq/l K: 4 mEq/l Creatinine: 0.5 mg/dl BUN: 10 mg/dl ESR: 120 mm/hr

Clinical trial eligibility criteria: eligible ages (years): 15.0-999.0,  MDR-TB Consent: Is willing and able to give informed consent to participate in the trial treatment and follow-up (signed or witnessed consent if the patient is illiterate). If the patient is below the age of consent (according to local regulations), the parent/caregiver should be able and willing to give consent, and the patient be informed about the study and asked to give positive assent, if feasible 2. Age: Is aged 18 years or older (Stage 1) or 15 years or older (Stage 2) 3. AFB or GeneXpert results: Has a positive AFB sputum smear result at screening (at least scanty), or a positive GeneXpert result (with a cycle threshold (Ct) value of 25 or lower) from a test performed at screening or from a test performed within the four weeks prior to screening 4. Has evidence of resistance to rifampicin either by line probe assay (Hain Genotype), GeneXpert or culture-based drug susceptibility testing (DST), from a test performed at screening or from a test performed within the four weeks prior to screening 5. Is willing to have an HIV test and, if positive, is willing to be treated with ART in accordance with the national policies but excluding ART contraindicated for use with bedaquiline 6. Is willing to use effective contraception: pre-menopausal women or women whose last menstrual period was within the preceding year, who have not been sterilised must agree to use a barrier method or an intrauterine device unless their partner has had a vasectomy; men who have not had a vasectomy must agree to use condoms. In Stage 2 pre-menopausal women or women whose last menstrual period was within the preceding year, who have not been sterilised must agree to use two methods of contraception, for example a hormonal method and a barrier method 7. Resides in the area and expected to remain for the duration of the study. 8. Has had a chest X-ray that is compatible with a diagnosis of pulmonary TB (if such a chest X-ray taken within 4 weeks of randomisation is available, a repeat X-ray is not required) 9. Has normal K+, Mg2+ and corrected Ca2+ at screening  Is infected with a strain of M. tuberculosis resistant to second-line injectables by line probe assay (Hain Genotype) from a test performed at screening or from a test performed within the four weeks prior to screening 2. Is infected with a strain of M. tuberculosis resistant to fluoroquinolones by line probe assay (Hain Genotype) from a test performed at screening or from a test performed within the four weeks prior to screening 3. Has tuberculous meningitis or bone and joint tuberculosis 4. Is critically ill, and in the judgment of the investigator, unlikely to survive more than 4 months 5. Is known to be pregnant or breast-feeding 6. Is unable or unwilling to comply with the treatment, assessment, or follow-up schedule 7. Is unable to take oral medication 8. Has AST or ALT more than 5 times the upper limit of normal for Stage 1, and AST or ALT more than 3 times the upper limit of normal for Stage 2 9. Has any condition (social or medical) which in the opinion of the investigator would make study participation unsafe 10. In the investigator's opinion the patient is likely to be eligible for treatment with bedaquiline according to local guidelines due to a pre-existing medical condition such as hearing loss or renal impairment 11. Is taking any medications contraindicated with the medicines in any trial regimen 12. Has a known allergy to any fluoroquinolone antibiotic 13. Is currently taking part in another trial of a medicinal product 14. Has a QT or QTcF interval at screening or immediately prior to randomisation of more than or equal to 500 ms for Stage 1, and more than or equal to 450 ms for Stage 2 In addition to the above, for Stage 2 only, a patient will not be eligible for randomisation to the study if he/she: 15. Has experienced one or more of the following risk factors for QT prolongation A confirmed prolongation of the QT or QTcF more than or equal to 450 ms in the screening ECG (retesting to reassess will be allowed once using an unscheduled visit during the screening phase) Pathological Q-waves (defined as Q-wave more than 40 ms or depth more than 0.4-0.5 mV) Evidence of ventricular pre-excitation (e.g., Wolff Parkinson White syndrome) Electrocardiographic evidence of complete or clinically significant incomplete left bundle branch block or right bundle branch block Evidence of second or third degree heart block Intraventricular conduction delay with QRS duration more than 120 ms Bradycardia as defined by sinus rate less than 50 bpm Personal or family history of Long QT Syndrome Personal history of cardiac disease, symptomatic or asymptomatic arrhythmias, with the exception of sinus arrhythmia