Management of Patient-wise Boxes in Different Scenarios

There are different scenarios regarding patient-wise box (PWB) management. These are described below.

Scenario 1: Modification in regimen

In this scenario, the nodal and district drug-resistant tuberculosis centre (N/DDR-TBC) committee decides on a regimen modification.

• The district drug store (DDS) prepares modified PWBs from standard available boxes and loose drugs and arranges the supply of these PWBs to the treatment supporter (TS).
• The district TB officer (DTO) ensures that the drugs are supplied as per the modified regimen for all subsequent months.

Scenario 2: Extension of intensive phase

If the intensive phase (IP) is extended:

• N/DDR-TBC informs the DTO
• DTO informs the health facility (HF) doctor and respective TB unit (TU)
• HF releases 1-month PWB to the respective treatment support centre from where the patient is taking treatment

When the patient is switched to the continuation phase (CP) in case of a shorter regimen:

• DTO, again, informs the HF doctor and respective TU

• HF releases 1-month PWB to the respective treatment support centre from where the patient is taking treatment

   

In the case of a longer regimen, after completion of 6-8 months of treatment, Linezolid (Lzd) should be reduced to 300 mg following N/DDR-TBC directives.

All patients must complete their monthly boxes before switching to the subsequent box provided.

Scenario 3: Change in DR-TB regimen

If N/DDR-TBC decides to change the DR-TB regimen of a patient, the DDS supplies a new treatment regimen box from PWB/ loose drugs. Unused drugs, including Bdq containers, should be returned to the DDS. In this scenario, the patient should be immediately switched to the new regimen designed by N/DDR-TBC.

Resources

• Guidelines for Programmatic Management of Drug Resistant Tuberculosis in India- March 2021

Kindly provide your valuable feedback on the page to the link provided HERE