After a delay of nearly a year, the State is expected to roll out the daily drug regimen for treatment of tuberculosis (TB) under the Revised National Tuberculosis Control Programme (RNTCP) in February this year. All drug procurement logistics and trainings have been completed by the State.
This is a major shift in the TB treatment policy being followed by the Central TB Division since 1997. Kerala is one of the five States where the new policy, the daily drug regimen, will be piloted.
Since 1997, patients under the RNTCP were being administered drugs thrice a week (the intermittent drug regimen). However, private sector physicians who treat a good number of TB patients preferred to put their patients on a daily regimen of tailor-made drug combinations and dosages.
Amidst arguments at various levels that this total variance in treatment practices and innumerable drug combinations were encouraging drug resistance and high default rate in treatment, the World Health Organisation revised its TB management guidelines in 2010, recommending that the daily drug regimen be adopted under RNTCP.
“Under the new daily drug regimen, TB patients will be given fixed drug combinations (FDCs) -- three or four drugs in specific dosages in a single pill -- on a daily basis. The drugs will also be administered in a more scientific manner according to patient’s weight. The biggest advantage for the patient under the new regimen will be reduced pill burden, as instead of seven tablets, patients need consume only 2 or 3 tablets, according to his weight band,” senior RNTCP officials said.
However, increased pharmacovigilance might be in order as the drug regimen goes from thrice weekly to daily. TB drugs are highly toxic and hence more clinical monitoring of patients will be required to manage adverse drug reactions
For child patients, new flavoured, dispersible tablets are being introduced and this is expected to improve treatment compliance to a large extent. Kerala, incidentally, has the lowest TB-affected child population at 6 per cent (2015) and the figures are more or less the same even in private sector
With the national programme too moving to the daily drug regimen, the State TB programme could see an increased enrolment of patients, by at least 20 per cent, it is expected.
Source: The Hindu