More effective drug for TB available, but not in India: doctors

Three years after a team of doctors identified the presence of extensive and extremely drug resistance (XXDR) TB in Mumbai in 2012, they also have succeeded in curing a patient who was battling the disease.

Three years after a team of doctors identified the presence of extensive and extremely drug resistance (XXDR) TB in Mumbai in 2012, they also have succeeded in curing a patient who was battling the disease.

Shirish Kanitkar (name changed), a young tailor from Mumbai Central was cured of XXDR a few days ago, said doctors treating him.

“Multiple tests to ascertain the presence of TB bacillus have been negative concluding that he’s been cured of XXDR TB,” said Dr Zarir F Udwadia, chest physician at Hinduja Hospital, Mahim who treated the patient. But, Kanitkar had to undergo a major surgery, in which one of his lungs had to be removed.

However, six of the 12 patients who were initially diagnosed with XXDR – at times referred to as totally drug-resistant (TDR) TB – died within a few months of diagnosis. Kanitkar’s case also highlights another significant aspect, which is of the drug that was used to treat him. He was administered bedaquiline, one of the recently developed TB drug.

“He was one of the first 12 XXDR patients that we’d diagnosed. And, also one of the first for whom we had requested for bedaquiline from its manufacturers on compassionate grounds,” said Dr Udwadia.

The drug has not yet been approved for sale in India yet. Doctors said that if the drug could be made accessible then the outcome of XXDR cases can change for better.

It is not just the treatment of TB that has advanced in last three years, but also the diagnosis.

The biggest issue against detection of extremely drug resistant TB— or XDR— is the time it takes to diagnose the condition.

The culture test takes more than 18 days.

But, a molecular diagnostics test, pyrosequencing, takes barely 8 hours to deliver the result.

Doctors said that so far as many as 700 patients have been tested, using this technique at Hinduja Hospital, which has got the machine as part of a worldwide trial.

However, these latest advancements have yet not been approved by the World Health Organisation (WHO), hence not a part of the treatment protocol.