Senate approval Wednesday came just one week after President Barack Obama named Petraeus, 57, as his choice to fill the post after General Stanley McChrystal was sacked over an explosive magazine profile in which he and his aides belittled civilian leaders.

The move means Petraeus relinquishes command of all US forces in the Middle East to take over a military campaign that has been stymied by a resilient Taliban foe, rising casualties and deep divisions within the administration.

At his confirmation hearing one day before his Senate confirmation, Petraeus warned anxious lawmakers that Western forces face "tough fighting" against Taliban insurgents.

"Indeed, it may get more intense in the next few months," Petraeus, arguably the most revered military officer in the United States, told the Senate Armed Services Committee.

Petraeus also warned it would take "a number of years" before Afghan security forces could take over for NATO-led troops, a step US officials have described as a precondition for a complete withdrawal.

It is the second time Petraeus has been called upon to turn around the country's fortunes in an unpopular war.

Former president George W. Bush turned to him in 2007 to salvage the US war effort in Iraq amid a headlong plunge into sectarian violence and spectacular suicide attacks that the US military appeared incapable of stopping.

The author of the US Army's new counter-insurgency manual, Petraeus used a "surge" in US forces to restore security in the cities and capitalized on divisions in the Sunni insurgency to turn it against Al-Qaeda in Iraq.

US forces in Iraq, which once numbered over 170,000, are on track to go to 50,000 by August.

From his perch at the US Central Command, Petraeus has backed a similar 30,000-troop surge in Afghanistan and argued for bringing to bear counter-insurgency lessons learned in Iraq.

Politically savvy and intensely competitive, Petraeus is easily the most celebrated general of his generation, a fact that has been known to rankle fellow army officers, who sometimes refer to him, cuttingly, as "King David."

The New York state native graduated from the US Military Academy at West Point in 1974, was the top of his 1983 class at the US Army Command and General Staff College, and went on to earn a PhD in international relations at Princeton University.

Petraeus commanded the 101st Airborne Division during the 2003 invasion of Iraq, and quickly pacified the northern region around Mosul.

He later headed up the troubled US effort to train Iraqi security forces, and then returned to the United States to oversee the writing of the manual for counter-insurgency warfare.

The media chronicled his rise. He was profiled in books about the invasion of Iraq, and declared one of the 25 most influential Americans by US News and World Report in 2005.

His televised appearances before a restive Congress in 2007 and 2008 to report on his progress in Iraq had the aura of a Roman festival.

No US general since William Westmoreland during the Vietnam War has been so dominant.

And his star has not dimmed despite a lower public profile over the past two years at the Tampa, Florida-based US Central Command.

When he fainted last week while testifying in Congress, it made headlines, and shocked senators.

Petraeus, a long distance runner who prides himself on outpacing much younger men, later dismissed the episode as due to dehydration, and a spokesman said he had been given a "clean bill of health."

However, he was diagnosed last year with early stage prostate cancer and underwent what his office said was "successful" radiation treatment at Walter Reed Army Medical Center.

He has escaped death twice, once when he was shot accidentally and then during a parachute jump that went wrong.

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