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No pricks: Oral TB drug for under 5 gets nod

Apr 12,2024

New Delhi: In the battle against drug-resistant tuberculosis (TB), young children have faced a particularly challenging hurdle: the painful injectables in treatment regimens. These medications, notorious for their severe side effects, added an extra layer of distress to an already daunting ordeal for infants and children. Now, with approval of Delamanid for children under 5 in India in March, doctors anticipate a significant shift in paediatric TB treatment.

In an important update to its treatment guidelines in March, Central TB Division announced an expansion in use of Delamanid for younger paediatric patients. Previously restricted to children above the age of six years, Delamanid is now endorsed for use in children, including infants, as part of the initial oral regimen for treating multi-drug resistant (MDR-TB) and extensively drug-resistant TB (XDR-TB), it said. The department said Delamanid can be administered according to recommendations for children weighing at least 10kg. Centres have been told to use 50mg dispersible tablets till 25mg tablets are available under the national programme.

This approval, albeit coming two years after global go ahead for young kids, signifies a major leap in paediatric TB treatment because doctors can finally offer young patients an all-oral regimen, free from the discomfort and potential harm associated with injectables.

Before this permission, treatment regimens for younger babies suffering from XDR-TB included injectables such as amikacin, a drug known for its potential to cause mild to severe hearing loss in children and adults alike.

Dr Sushant Mane, national expert in National TB Elimination Programme (NTEP) from JJ Hospital, called it a “transformational” development that will bring relief not just to children but also to their families. In drug-resistant TB, children go through a daunting 18-month treatment regimen, where they have to take daily injections for six months. “But it’s not just about the pain of each needle prick; it’s the constant fear of abscesses and secondary infections at the injection site,” the doctor said.

The news has special implications for Mumbai, said chest physician and TB specialist Dr Vikas Oswal, where 51 per cent cases are pre-XDR and XDR.

Source: Healthworld

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