Indian Journal of Community Medicine

LETTER TO EDITOR
Year
: 2009  |  Volume : 34  |  Issue : 2  |  Page : 166-

XDR tuberculosis: A looming threat


Vishal Sharma, Sourabh Aggarwal 
 Department of Medicine, University College of Medical Sciences, Delhi, India

Correspondence Address:
Vishal Sharma
Department of Medicine, University College of Medical Sciences, Delhi
India




How to cite this article:
Sharma V, Aggarwal S. XDR tuberculosis: A looming threat.Indian J Community Med 2009;34:166-166


How to cite this URL:
Sharma V, Aggarwal S. XDR tuberculosis: A looming threat. Indian J Community Med [serial online] 2009 [cited 2019 Jun 26 ];34:166-166
Available from: http://www.ijcm.org.in/text.asp?2009/34/2/166/51215


Full Text

Sir,

Grover, et al. have reviewed the recent advances in drug resistant tuberculosis. [1] In this regard, it is important not to forget the recent threat of extensively drug resistant (XDR) tuberculosis that is resistant to isoniazid, rifampin, a fluoroquinolone, and any injectable drug (aminoglycosides or polypetides). [2] The cases of XDR have been reported from across the globe. It is also a cause of major concern in India. [3] This strain requires multiple second-line drugs for treatment and early reports indicated very high case fatality rates. This was probably due to concurrent HIV infection. [2] In this entire gloomy scenario, there is at least one silver lining from the recent report from Peru. In that report, individualized treatment of HIV-negative XDR cases yielded results comparable to MDR tuberculosis. [4] The importance for India lies in the fact that Peru, much like us, is a developing country.

The objective for us, however, is to prevent the emergence and transmission of such a strain. The most important risk factor implicated in the occurrence of XDR cases is inadequate or inappropriate management of tuberculosis. Hence, there is an urgent need to strengthen services of DOTS and DOTS-Plus under RNTCP. Only an efficient first-line therapy in the form of DOTS can stop XDR tuberculosis from being a major public health concern in the days to come.

References

1Grover GS, Takkar J. Recent advances in multi-drug-resistant tuberculosis and RNTCP. Indian J Community Med 2008;33:219-23.
2Madariaga MG, Lalloo UG, Swindells S. Extensively drug-resistant tuberculosis. Am J Med 2008;121:835-44.
3Udwadia ZF, Jain S, Rodrigues C, Mehta A. XDR tuberculosis in India: what's in a name? Lancet Infect Dis 2007;7:441-2.
4Mitnick CD, Shin SS, Seung KJ, Rich ML, Atwood SS, Furin JJ, et al . Comprehensive treatment of extensively drug-resistant tuberculosis. N Engl J Med 2008;359:563-74.