Cross roads in the management of Multi Drug Resistant Tuberculosis (MDR-TB)

MDR-TB is a growing menace and stumbling block to adequate control of TB. Inappropriate treatment regimens, inadequate duration of treatment and non-adherence to treatment are the leading causes for resistance. Therefore MDR-TB can be considered as a result of human errors in management. Along with protocol based treatment, adherence and tolerance to treatment has to be ensured to counter further development of resistance. The regimen recommended by WHO and PMDT India differs, but the basic principle is the same. The knowledge of treatment regimen and their adverse effects help in prescribing suitable regimens for a patient. Serious drug reactions requiring stoppage of drugs are rare. The most important aspect in dealing with MDR-TB is that the treatment should be initiated and done by an expert in the field. Demonstration of drug resistance is difficult in some cases despite having strong suspicion of MDR-TB which needs further addressal by policy makers.