Newer Anti-TB Drugs: Delamanid [Dlm]

Delamanid (Dlm) is the first approved drug in the class of nitro-dihydro-imidazo-oxazoles for the treatment of Multi-drug Resistant TB (MDR-TB). 

Figure: Delamanid (DLM) Tablets

Mechanism of Action

It is a bactericidal drug with 36 hours of half-life and acts with two different mechanisms of action.

1. It blocks the synthesis of mycolic acids, i.e., stops the bacteria from creating building blocks that are important for their cell walls.
2. It poisons the bacilli with nitric oxide, which the drug releases when metabolized.

​National TB Elimination Programme (NTEP) has provision for the use of this drug containing regimen for the management of Drug-resistant Tuberculosis (DR-TB) since Jan '18.

Resources

• Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, March 2021.
• World Health Organization. The use of Delamanid in Treatment of Multidrug-resistant Tuberculosis: Interim Policy Guidance, 2016.
• Guidelines for the Use of Delamanid in the Treatment of Drug-resistant TB in India, 2018.
• Consolidated Guidelines on Tuberculosis, Module 4 - Treatment: Drug-resistant TB Treatment.

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