A 32-year-old HIV-positive patient newly enrolled in the NTEP has a sputum Gene Xpert MTB/RIF result: MTB DETECTED; RIF resistance DETECTED. What is the correct NTEP treatment regimen?
- A Conventional MDR-TB regimen with 6 drugs for 18-24 months
- B Standard 2HRZE/4HR regimen
- C Shorter oral BPaLM regimen (Bedaquiline, Pretomanid, Linezolid, Moxifloxacin) ✓
- D Pre-XDR regimen with Imipenem-Cilastatin plus Delamanid
Correct answer: C. Shorter oral BPaLM regimen (Bedaquiline, Pretomanid, Linezolid, Moxifloxacin)
Explanation
India's NTEP (2023 guidelines) has adopted the shorter all-oral BPaLM (Bedaquiline, Pretomanid, Linezolid, Moxifloxacin) regimen for confirmed RIF-resistant/MDR-TB patients, replacing the longer conventional regimen. BPaLM is 6 months in duration, significantly shorter than the previous 18-24-month regimen, with improved outcomes and oral-only route. The standard 2HRZE/4HR regimen is for DS-TB only. Pre-XDR TB requires BPaL ± other drugs.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.