👤 Nitin Kumbhar

Drug resistant Tuberculosis (DR-TB) continues to be a major concern for public health, particularly in countries like India with high disease burden. Recognizing resistance trends and appropriate therapeutic approach is critical for improving patient outcomes and updating national treatment protocols. This study aims to analyze drug resistance patterns and assess treatment modifications made in accordance with National Tuberculosis Elimination Programme (NTEP). The study was conducted in our institute in western Maharashtra over a period of 18 months after approval from ethics committee which included microbiologically confirmed pulmonary and extrapulmonary DR-TB cases and resistance patterns were studied using molecular and phenotypic drug susceptibility testing (DST) including line probe assays (LPA). Initial treatment regimens and subsequent modifications were documented and assessed. Out of 83 DR-TB patients the most prevalent pattern was Isoniazid monoresistance (H Mono DRTB) (45.78 %), followed by Rifampicin resistant TB (RR-TB) (21.69 %) and Pre - extensively drug resistant TB (Pre XDR-TB) (24.10 %). Majority were initiated on an All Oral Longer Regimen (49.40 %) or an H Mono/Poly DR-TB regimen (48.19 %). Modifications were required in 28.92 % of the cases with fluoroquinolones being the most frequently substituted drug due to resistance. Out of 83 individuals, only 55 were assigned outcomes since the remaining were on treatment. Among these 55, 72.7 % were assigned outcome as cured, 5.4 % as treatment completed, 10.9 % defaulted, 3.6 % as treatment failed and 7.27 % died. The study highlights the evolving resistance pattern in DR-TB patients and need for patient specific treatment to achieve optimal outcomes. It also provides valuable insights for effective management protocols, contributing to improved patient prognosis and informing public health strategies. Show less