What is MDR? Why is it on the rise?
If anti-TB medicines are used inappropriately, they quickly become ineffective.
Inappropriate treatment in TB takes place in several forms:
a. To give up medication prematurely, as soon as one feels better. Not completing the full course of 6-8 months.
c. Accepting treatment from a quack.
d. Inaccurate diagnosis.
e. Inappropriate drugs / combinations.
f. Inadequate dosages; not as per one’s body weight.
g. To pick and choose tablets at will; not to swallow each and every pill in your recommended dose but to selectively discard one or two tablets.
h. To accept substandard or expired medicines.
i. To frequently change doctors and drug regimes.
Each of the 9 above may contribute towards making TB medicines ineffective on the causative germ – in other words, turn the germs resistant to medicines.
It takes over a decade of R&D to evolve a medicine. Ironically, only a few months of its misuse may render it ineffective. Given the slightest of opportunity, the resilient TB bacillus rapidly learns to dodge the medicine and resist it. That is why TB is never treated with a single drug but with a combination of 2-5 drugs given simultaneously.
Once the germ becomes resistant to the first 2 of the 5 main anti-TB medicines (HR EZS), it is called Multi Drug Resistant TB. This is confirmed by ‘Culture and Drug Sensitivity test’, which is time consuming, expensive and scarcely available.