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Types of monthly PWB
Learning ObjectivesType A and Type B. Table to mention about the regimen
There are two types of monthly Patient Wise Boxes (PWB) issued to the TB patients.
1) Type A: Contains oral drugs that are used for treatment during both the Intensive Phase (IP) and Continuation Phase (CP).
2) Type B: Contains injectables which are prescribed for Intensive Phase (IP) only
Based on the regimen and weight band of the patients , PWB are prepared and issued to the patients.
Contents of PWB
- PWB for Shorter Oral Bedaquiline-containing MDR/RR-TB Regimen: Constitutes both Type A and Type B box
Type A box | Use in Intensive Phase (IP) as well as Continuation Phase (CP) | ||||
Drugs | Strength | 16-29 kg | 30-45 kg | 46-70 kg | >70 kg |
Tab. Levofloxacin* | 250/ 500 mg | 250 mg *30 tab | 250 mg *30 tab + 500 mg *30 tab | 500 mg *60 tab | 500 mg *60 tab |
Tab. Clofazimine | 50/ 100 mg | 50 mg *30 tab | 100 mg *30 tab | 100 mg *20 tab | 100 mg *60 tab |
Tab. Ethambutol | 400/ 800 mg | 400 mg *30 tab | 800 mg *30 tab | 400 mg *30 tab + 800 mg *30 tab | 600 mg *60 tab |
Tab. Pyrazinamide | 500/ 750 mg | 750 mg *30 tab | 500 mg *30 tab + 750 mg *30 tab | 500 mg *60 tab + 750 mg *30 tab | 500 mg *30 tab + 750 mg *60 tab |
Tab. Pyridoxine | 50/100 mg | 50 mg *30 tab | 100 mg *30 tab | 100 mg *30 tab | 100 mg *30 tab |
* When moxifloxacin is prescribed under exceptional conditions instead of levofloxacin, the modified box with moxifloxacin (normal dose) can be prepared from the standard box at DDS.
Type B box | Use in IP | ||||
Drugs | Strength | 16-29 kg | 30-45 kg | 46-70 kg | >70 kg |
Tab. Isoniazid | 100/ 300 mg | 300 mg *30 tab | 300 mg *60 tab | 300 mg *90 tab | 300 mg *90 tab |
Tab. Ethionamide | 125/ 250 mg | 125 mg *30 tab + 250 mg *30 tab | 250 mg *60 tab | 250 mg *90 tab | 250 mg *120 tab |
Bedaquiline bottle | 100 mg | Jar of 188 tablets for full course |
- PWB for Shorter Injectable-containing Regimen: Constitutes both Type A and Type B box
Type A box | Use in Intensive Phase (IP) as well as Continuation Phase (CP) | ||||
Drugs | Strength | 16-29 kg | 30-45 kg | 46-70 kg | >70 kg |
Tab. Moxifloxacin-High Dose | 400 / 800 mg | 400 mg *30 tab | 400 mg *30 tab | 400 mg *60 tab | 400 mg *60 tab |
Tab. Clofazimine | 50/ 100 mg | 50 mg *30 tab | 100 mg *30 tab | 100 mg *20 tab | 100 mg *60 tab |
Tab. Ethambutol | 400/ 800 mg | 400 mg *30 tab | 800 mg *30 tab | 400 mg *30 tab + 800 mg *30 tab | 600 mg *60 tab |
Tab. Pyrazinamide | 500/ 750 mg | 750 mg *30 tab | 500 mg *30 tab + 750 mg *30 tab | 500 mg *60 tab + 750 mg *30 tab | 500 mg *30 tab + 750 mg *60 tab |
Tab. Pyridoxine | 50/100 mg | 50 mg *30 tab | 100 mg *30 tab | 100 mg *30 tab | 100 mg *30 tab |
Type B box | Use in IP | ||||
Drugs | Strength | 16-29 kg | 30-45 kg | 46-70 kg | >70 kg |
Inj. Kanamycin | 15mg/kg/day | 500 mg *24 inj. | 750 mg * 24 inj. | 750 mg *24 inj. | 1000 mg *24 inj. |
Tab. Isoniazid-high dose | 100/ 300 mg | 300 mg *30 tab | 300 mg *60 tab | 300 mg *90 tab | 300 mg *90 tab |
Tab. Ethionamide | 125/ 250 mg | 125 mg *30 tab + 250 mg *30 tab | 250 mg *60 tab | 250 mg *90 tab | 250 mg *120 tab |
- PWB for Longer Oral M/XDR-TB Regimen : Constitutes only Type A box as there is no separate IP/CP under this regimen
Standard PWB | Continue till Complete Treatment | ||||
Drugs | Strength | 16-29 kg | 30-45 kg | 46-70 kg | >70 kg |
Tab. Levofloxacin | 250 / 500 mg | 250 mg *30 tab | 500 mg *30 tab + 250 mg *30 tab | 500 mg *60 tab | 500 mg *60 tab |
Tab. Linezolid# | 600 mg | 600 mg *30 tab# | 600 mg *30 tab | 600 mg *30 tab | 600 mg *30 tab |
Tab. Clofazimine | 50/ 100 mg | 50 mg *30 tab | 100 mg *30 tab | 100 mg *30 tab | 100 mg *30 tab |
Tab. Cycloserine | 250 mg | 250 mg *30 tab | 250 mg *60 tab | 250 mg *90 tab | 250 mg *120 tab |
Tab. Pyridoxine | 50/100 mg | 50 mg *30 tab | 50 mg *30 tab | 50 mg *30 tab | 50 mg *30 tab |
Bedaquiline bottle | 100 mg | 1 Jar (Jar of 188 tablets for full course) |
# Tab. Linezolid available in 600 mg only. When prescribed with modified dose of 300 mg Once Daily (OD), patient should be advised to divide the pill in half.
- PWB for H-mono/poly DR-TB Regimen: Constitutes only Type A box as there is no separate IP/CP under this regimen
Standard PWB | Continue till complete treatment | ||||
Drugs | Strength | 16-29 kg | 30-45 kg | 46-70 kg | >70 kg |
Tab. Levofloxacin | 250/ 500 mg | 250 mg *180 tab | 250 mg *180 tab + 500 mg *180 tab | 500 mg *360 tab | 500 mg *360 tab |
Tab. Rifampicin | 150/ 300/ 450 mg | 300 mg *180 tab | 450 mg *180 tab | 300 mg *360 tab | 300 mg *360 tab + 150 mg *180 tab |
Tab. Ethambutol | 400/ 800 mg | 400 mg *180 tab | 800 mg *180 tab | 400 mg *180 tab + 800 mg *180 tab | 800 mg * 360 tab |
Tab. Pyrazinamide | 500/ 750 mg | 50 mg *180 tab | 7750 mg *180 tab + 500 mg *180 tab | 750 mg *180 tab + 500 mg *360 tab | 750 mg *360 tab + 500 mg *180 tab |
Tab. Pyridoxine | 50/100 mg | 50 mg *180 tab | 100 mg *180 tab | 100 mg *180 tab | 100 mg*180 tab |
In comparison to other DR-TB regimens, a full treatment course should be prepared for the entire duration of 6 months.
Resources
- Standard Operating Procedure Manual Procurement & Supply Chain Management, CTD, MoHFW,India,2018
- Procurement, Supply Chain Management & Preventive Maintenance, Module 6, CTD, MoHFW, India.
Assessment
Question | Answer 1 | Answer 2 | Answer 3 | Answer 4 | Correct answer | Correct explanation | Page id | Part of Pre-test | Part of Post-test |
Which type of drug box is issued to the patient on all oral H-mono/ poly regimen? | Type A | Type B | Type A & Type B | Type C | 1 | A patient initiated on all oral H-mono/poly DR-TB regimen will receive the monthly type A box. | Yes | Yes |
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