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Multi-Drug Resistant and Extensively-Drug Resistant Tuberculosis

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Abstract

India is one of the high burden countries for tuberculosis (TB) including multi-drug resistant TB (MDR-TB) and extensively-drug resistant (XDR) TB. Drug-resistant (DR) TB has threatened the TB care and is a major health problem in many countries; treatment of DR TB has been difficult requiring use of reserve or second-line drugs, cost factors, has extensive side-effect profile and long duration of treatment. Treatment in MDR-TB are increasingly becoming individualised mainly due to preference for oral over injectable, results of drug susceptibility testing (DST), population resistance levels, history of previous TB treatment, drug tolerability and drug-to-drug interactions. Bedaquilline (BDQ) and delaminid (DLM) are new drugs available for treatment of these patients. World Health Organization (WHO) recommends use of BDQ in more than 15 y (>15 kg) patients only. Under Revised National Tuberculosis Control Programme (RNTCP) the use of this drug is recommended for patients older than 18 y only. Under RNTCP, the use of DLM is approved in children 6 y and above. Pediatric MDR/XDR TB treatment outcome with newer anti-TB drugs and regimen is lacking. Children when treated with individualized regimens have improved survival.

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Authors and Affiliations

  1. Pediatric TB and DR-TB Clinic, Department of Pediatric Infectious Diseases, B J Wadia Hospital for Children, Mumbai, 400012, India

    Ira Shah, Vishrutha Poojari & Himali Meshram

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  1. Ira Shah
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  2. Vishrutha Poojari
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  3. Himali Meshram
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IS, VP and HM did review of literature and wrote the manuscript. IS did critical review of the manuscript and will act as guarantor of the paper.

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Correspondence to Ira Shah.

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Shah, I., Poojari, V. & Meshram, H. Multi-Drug Resistant and Extensively-Drug Resistant Tuberculosis. Indian J Pediatr 87, 833–839 (2020). https://doi.org/10.1007/s12098-020-03230-1

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