MUMBAI: Majority of Indian multi-drug resistant TB (MDR-TB) patients may not benefit from the shorter treatment regimen spanning nine to 11 months that has worked effectively in several other countries. A study conducted by a city hospital has found the reason is most MDR-TB patients are resistant to second-line TB drugs and injectables that form the backbone of the shorter regime. Presently, MDR-TB treatment runs up to 24 months, besides being painful and causing serious side-effects. Doctors at Mahim's PD Hinduja Hospital have published a study in the BMC Infectious Diseases journal stating only 3% MDR-TB patients will qualify for the 'short course' regimen that relies on antibiotics fluoroquinolones and second-line injectable drugs. Evaluation of 559 patients showed that 75% were already resistant to fluoroquinolones, injectable drugs amikacin, kanamycin and anti-TB drug rifampicin. When their samples were studied for sensitivity to all drugs in the short course regimen, as many as 97% patients were resistant.
Interestingly, the Hinduja findings have come at a time when results of the first multi-country trial are just out. The STREAM trial carried out in Vietnam, Mongolia, South Africa and Ethiopia showed the short-course treatment outcome was as good as the conventional two-year regimen (79-80%).
"The STREAM trial findings, though exciting, may not hold true for Indian patients, where the resistance patterns are complex," said chest physician Dr Zarir Udwadia and lead researcher of the Hinduja study.