Is Shorter Treatment Regimen for Multidrug-resistant Tuberculosis feasible in Indian Children?

Traditionally, patients with rifampicin-resistant (RR) or multi-drug resistant tuberculosis (MDR-TB) are treated with a combination of second-line drugs, usually for 18 months or more [1]. Recently, World Health Organization (WHO) recommended a shorter and cheaper treatment regimen for MDR-TB [2]. Standardized shorter MDR-TB regimen consists of seven drugs and a treatment duration of 9-12 months [1]. The regimen consists of 4-6 months of kanamycin, high-dose moxifloxacin (12 mg/kg/day, not to exceed 800 mg daily), prothionamide or ethionamide, clofazimine, pyrazinamide, high dose isoniazid (15 mg/kg, not to exceed 900 mg daily) and ethambutol followed by 5 months of moxifloxacin, clofazimine, pyrazinamide and ethambutol [1]. These recommendations were based on studies carried out in several countries – mostly in Africa [1,3].