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Let us understand the objective and importance of Pre-treatment Evaluation (PTE) of Drug-resistant TB (DR-TB) patients.
PTE Objective
Drugs used for the treatment of drug-resistant TB have significant adverse effects. Hence, there is a need for PTE to rule out any underlying condition at the baseline, like co-morbid conditions, radiological abnormalities, Electrocardiogram (ECG) changes, or biochemical derangements. 
PTE is essential to identify:
  • The patient's eligibility for initiation of a particular regimen
  • Patients who require special attention during treatment
  • Regimen modifications from the beginning of treatment


Important Points 

  • In the majority of Multidrug-resistant (MDR)/ Rifampicin-resistant Tuberculosis (RR-TB) patients, PTE can be done on an outpatient basis.
  • The District TB Officer (DTO) and Medical Officer of the TB Unit (MO-TU) can arrange for PTE at the Nodal and District DR-TB Centre (N/DDR-TBC) or at the sub-district level health facility, wherever feasible.
  • No additional investigations are required for H Mono/ Poly DR-TB patients unless clinically indicated.
  • The PTE carried out at the time of treatment initiation can be considered valid for 1 month from the date of the test result and the patient can be re-initiated on a subsequent regimen considering the previously conducted PTEs.
  • Active Drug Safety Management and Monitoring (aDSM) treatment initiation forms are required to be completed for all DR-TB patients at the time of initiation of each new episode of treatment.
  • PTE should include a thorough clinical evaluation by a physician and expert consultation as per the need. 
  • Laboratory-based tests should be performed based on the drugs used in the treatment regimen.
  • Pre-treatment evaluation should be made available free of charge to the patient.




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