Key Questions Answered
Q1: What is MDR-TB?
MDR-TB (Multi Drug Resistant Tuberculosis) is a form of Tc B in which the bacteria become resistant to the two most important first-line drugs—isoniazid and rifampicin.
Q2: How does MDR-TB develop?
It commonly develops due to incomplete or interrupted treatment, irregular intake of medicines, incorrect treatment regimens, and
Transmission from an existing MDR-TB patient
Q3: What are the symptoms of MDR-TB?
Symptoms are similar to usual TB: like Persistent cough, Fever,Weight loss,
Weakness etc.
However, a key feature is lack of improvement despite treatment.
Q4: How is MDR-TB diagnosed?
It is diagnosed using advanced tests such as:
CBNAAT / Truenat
Line Probe Assay (LPA)
Culture & Drug Sensitivity Testing (DST)
These tests identify which drugs will be effective.
Q5: What is XDR-TB?
XDR-TB (Extensively Drug Resistant TB) is a more severe form of MDR-TB, where the bacteria are resistant to several additional important second-line drugs. Treatment becomes more challenging but is still possible under expert care.
Q6: Is MDR/XDR-TB treatable?
Yes. Treatment is available, though it may be longer and more complex, involving second-line drugs and careful monitoring.
Q7: Are there any new treatment advances? (What is the BPaLM regimen?)
Yes. A major recent advancement is the BPaLM regimen, which includes Bedaquiline, Pretomanid, Linezolid, and Moxifloxacin. In selected patients, this shorter regimen (around 6 months) has shown promising results.
Q8: Is BPaLM suitable for all patients?
No. It is recommended only for selected MDR/XDR-TB patients, based on clinical evaluation and test results.
Q9: Is treatment available free of cost?
Yes. Under the National TB Elimination Programme, diagnosis and treatment of MDR/XDR-TB are completely free, including newer drugs.
Q10: What precautions should patients take during treatment?
Take medicines regularly without interruption
Do not stop treatment on your own, Report side effects promptly,
Maintain good nutrition and rest.
Q11: Can MDR/XDR-TB spread to others?
Yes. If not treated properly, it can spread to others. Early diagnosis and complete treatment are essential to prevent transmission.
Conclusion: Dr S K Arora says that MDR and XDR-TB are serious conditions, but with early detection, newer treatment options like BPaLM, and strict adherence, they can be effectively managed. Incomplete treatment remains the biggest risk factor.
Dr. S.K. Arora
Senior Chest Specialist,Consultant,
Ex-Delhi State TB Head, Delhi Government.
(Recipient of WHO Award)
