'Personalizing' shorter regimens: Need of the hour

Area of Science:

• Medicine
• Infectious Diseases
• Public Health

Background:

• The implementation of injectable shorter regimens for Programmatic Management of Drug-Resistant Tuberculosis (PMDT) in 2017 aimed to reduce treatment duration for Drug-Resistant Tuberculosis (DRTB) patients.
• This approach was a significant advancement under the Revised National Tuberculosis Control Program (RNTCP).

Purpose of the Study:

• To evaluate the treatment outcomes of patients initiated on injectable shorter regimens between March 2018 and May 2019.
• To identify factors associated with successful treatment outcomes in DR-TB patients receiving these regimens.

Main Methods:

• A retrospective study analyzing medical records of 85 patients on injectable shorter regimens.
• Data collected included patient demographics (age, gender, weight, HIV status), comorbidities (diabetes mellitus, anemia), treatment initiation gap, intensive phase duration, and sputum conversion time.

Main Results:

• Overall successful treatment outcome was observed in 56.5% of patients.
• Demographic factors and comorbidities like diabetes mellitus and anemia were not significantly associated with treatment success.
• Duration of the intensive phase, time to sputum conversion, and timing of outcome were significant predictors of successful treatment.

Conclusions:

• Injectable shorter regimens are effective across diverse patient populations, regardless of demographic differences.
• Close patient monitoring is crucial, with microbiological parameters like sputum conversion serving as early indicators of treatment success or failure.
• These regimens offer a viable alternative for patients unable to tolerate all-oral shorter regimens, such as those containing Bedaquiline.