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Eligibility Criteria for Longer Oral M/XDR-TB Regimen
Learning ObjectivesEligibility Criteria for Longer Oral M/XDR-TB Regimen
Longer oral Multi (M)/ Extensively-drug Resistant TB (XDR-TB) regimen is recommended for Multi-drug Resistant (MDR)/ Rifampicin-resistant TB (RR-TB) patients who are excluded from shorter oral Bedaquiline-containing MDR/ RR-TB regimen including for the XDR-TB patient.
A patient would be re-evaluated in any of the following conditions and initiated on a longer oral M/XDR-TB regimen at Nodal (N)/ District DR-TB Centre (DDR-TBC) with any modifications:
- Additional resistance
- Intolerance or non-availability of any drug in use
- Emergence of exclusion criteria
- Return after lost-to-follow-up (LTFU)
- Failed to shorter oral Bedaquiline-containing MDR/ RR-TB regimen or any longer regimen
The decision will also be based on Drug Susceptibility Test (DST) results, especially for Levofloxacin (Lfx), Moxifloxacin (Mfx), Bedaquiline* (Bdq), Linezolid (Lzd), Clofazimine* (Cfz), Delamanid* (Dlm) and Pyrazinamide (Z) (*whenever available).
The regimen modification would be done using a replacement of the sequence from group C drugs.
Resources
- Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, March 2021.
- WHO Consolidated Guidelines on Tuberculosis: Module 4 - Treatment: Drug-resistant TB Treatment, 2020.
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First paragraph to be…
Dr. Priyadarshini Tue, 09/01/2024 - 14:36
First paragraph to be rephrased. Treatment for person with XDR-TB not clearly brought out.