Under NTEP, a patient who was previously treated and is returning after default (>2 months) should be classified as:

• A New case — same regimen as first treatment
• B Treatment after loss to follow-up (TALF) — DST-guided Category II regimen
• C Multidrug-resistant TB — empirically start BPaL regimen
• D Treatment after loss to follow-up — DST must be done and treatment guided by susceptibility results ✓

Explanation

NTEP 2021 guidelines classify previously treated patients returning after loss to follow-up as 'Treatment after loss to follow-up (TALF)'. Drug susceptibility testing (DST) — ideally molecular (Xpert MTB/RIF or LPA) followed by culture-based DST — is mandatory before restarting treatment, and the regimen is guided by susceptibility results. Category II (HRZES + HRZE + HRE) is no longer the routine approach for TALF patients.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.