Longer Oral M/XDR-TB: Regimen and Duration

Longer oral Multi (M)/ Extensive Drug-resistant (XDR) -TB treatment is specified with a definite regime and duration.

Regimen: (18-20) Levofloxacin (Lfx), Bedaquiline (Bdq) (6 months or longer), Linezolid^# (Lzd), Clofazimine (Cfz), Cycloserine (Cs)​​ (^# dose of Lzd will be tapered to 300 mg after the initial 6–8 months of treatment)​

• Duration: 18-20 months
• No separate Intensive Phase (IP) and Continuation Phase (CP).
• Bdq will be given for 6 months and extended beyond 6 months as an exception.
• Pyridoxine should be given to all Drug-resistant TB (DR-TB) patients as per the weight bands.
• For Extensively Drug-resistant TB (XDR-TB) patients, the duration of a longer oral XDR-TB regimen would be for 20 months.

Resources

• Guidelines for Programmatic Management of Drug-Resistant Tuberculosis in India, March 2021.
• WHO Consolidated Guidelines on Tuberculosis: Module 4 – Treatment: Drug-resistant TB Treatment, 2020.

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