India to roll out new treatment regimen for drug-resistant TB

Sub: Sci

Sec: Health

Context:

India is getting ready to roll out BPaL (bedaquiline, pretomanid, and linezolid) regimen for all multi/extensively drug-resistant tuberculosis patients and the training for this new exercise is scheduled to begin this month.

What is BPaL Regimen?

BPaL is a 6-month, all-oral, three-drug regimen that is used to treat people with highly drug-resistant forms of TB.
BPaL is a combination of three newer antibiotics, namely bedaquiline, pretomanid and linezolid.
BPaL will drastically cut short the treatment duration by half (and more) and reduce the amount of medication an MDR-TB patient must take during treatment to around six months.
It is entirely oral with NO injectable, making it easier for patients to adhere to the treatment.
Bedaquiline (Bdq):
- Targets ATP synthase enzyme in Mycobacterium tuberculosis, disrupting energy production.
Pretomanid (Pa):
- Inhibits bacterial cell wall synthesis and kills bacteria under anaerobic conditions.
- Enhances effectiveness when combined with other TB drugs.
Linezolid (Lzd):
- Inhibits protein synthesis, stopping bacterial growth.
- Effective against MDR and XDR TB strains.

What is Multidrug-resistant tuberculosis (MDR-TB)?

Multidrug-resistant tuberculosis (MDR-TB) is a form of TB caused by bacteria that do not respond to isoniazid and rifampicin, the 2 most powerful, first-line anti-TB drugs.
MDR-TB is treatable and curable by using second-line drugs such as Bedaquiline.
India has a 56% treatment success rate for MDR/RR-TB cases, and 48% for XDR-TB cases, attributable to long and toxic drug regimens.

How is TB diagnosed?

A nucleic acid amplification test, or NAAT, for tuberculosis (TB) is a molecular test used to detect the DNA (deoxyribonucleic acid) of Mycobacterium tuberculosis complex (MTBC) in a sputum or other respiratory sample.