Following reports from the National Tuberculosis Institute (NTI) in Bangalore confirming that eight TB patients from Mumbai are indeed totally resistant to all drugs,doctors now are looking at alternative treatment for them. In a meeting held at the Sewri TB Hospital on Wednesday as part of the DOTS plus programme,chest physicians discussed the modification in treatment.
The report states that the eight patients are resistant to both first and second line of treatment. So,now a change in regimen has to be made according to the drug resistance shown by the patients. For example,if the patient is resistant to a particular TB drug,that drug will be discontinued and similar antibiotic drugs,such as the ones used to treat leprosy,can be administered, said BMCs TB officer,Dr Mini Khetarpal.
Apart from these eight patients,two others suffering from Extra Extensive Drug-resistant TB (XXDR-TB) were found to be sensitive to only one drug. Drug resistance in patients was determined by subjecting their sputum samples to first and second line drugs. Most samples showed resistance to more than four drugs from each line of treatment.
Many of these drugs have significant adverse effects and considering the span of treatment,it is critical to administer the drugs carefully. The first six months of treatment is the intensive phase followed by the continuation phase.
Patients have to undergo treatment for at least two years. If they are responding to certain drugs now,there is no way of knowing if they will continue to respond to it over the course of treatment. It is long-drawn process, Khetarpal said.
State officer for TB Dr P Y Gaikwad,on the other hand,dismissed the results of the report sent by NTI. The patients are slowly but surely responding to treatment,even though the lab reports state otherwise. The response time for each patient varies according to individual immunity, he said.
In January,doctors at P D Hinduja Hospital had diagnosed 12 patients with XXDR-TB. Three of them died,while two more were diagnosed with the condition in the past three months.
Doctors at Hinduja said while patients had been put on salvage drugs,chances of their long-term survival are slim.