Under NTEP, a patient diagnosed with RR-TB (rifampicin-resistant TB) who has not previously received second-line drugs is classified as:

• A Category IV, treated with BDQ-LFX-ETO-Z-Cs regimen
• B Pre-XDR TB and referred for longer regimen
• C New RR/MDR-TB and eligible for shorter BPaLM regimen (BDQ, Pa, LZD, Mfx) ✓
• D Category II failure, retreated with SHRZE regimen

Explanation

The WHO 2022 guidelines (adopted under NTEP) recommend the BPaLM regimen (Bedaquiline, Pretomanid, Linezolid, Moxifloxacin) for new RR/MDR-TB patients without prior second-line exposure. This 6-month regimen is shorter than older 18–20 month regimens and replaces the older Category IV injection-based treatment. Pre-XDR TB refers to additional resistance to fluoroquinolones. The SHRZE Category II regimen was discontinued with RNTCP 2016 revision.

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

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Written and medically reviewed by the StethoPrep medical team.