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Indian doctors demand better second line treatment for patients with drug resistant tuberculosis

BMJ 2009; 338 doi: http://dx.doi.org/10.1136/bmj.b8 (Published 07 January 2009) Cite this as: BMJ 2009;338:b8
  1. Ganapati Mudur
  1. 1New Delhi

    India’s national tuberculosis control programme is providing inappropriate drugs to thousands of patients, amplifying the public health hazard posed by multidrug resistant tuberculosis, sections of India’s medical community have said.

    Doctors campaigning for change want drug sensitivity tests given to patients when initial treatment fails so that individualised treatment can be given.

    The initial course of treatment given to patients in India consists of rifampicin, isoniazid, pyrazinamide, and ethambutol. If these fail patients are given a regimen that consists simply of adding streptomycin to the original four.

    The programme, managed by the health ministry and based on the directly observed treatment, short course strategy, provides drugs each year to about 1.5 million patients and has a success rate of 85%.

    But among 19 436 patients who received the retreatment course in 2006 after failing previous treatment, the cure rate was only …

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