All women of childbearing age who are awaiting results of the Culture and Drug Susceptibility Test (C&DST), as well as those receiving Drug-resistant TB (DR-TB) treatment, should be advised and counselled intensively to use birth control measures because of the potential risk to both the mother and the foetus.​

The principles for the treatment and monitoring of Multidrug-resistant (MDR)/ Rifampicin-resistant TB (RR-TB) in children are quite similar to adults and use the same second-line drugs. 

Principles 

Apart from clinical evaluation, the patients need to be closely assessed by various laboratory parameters to monitor the improvement on treatment, drug-induced adverse events or co-morbidities to enable timely interventions to address these and improve the probability of treatment success, survival and quality of life.

The following points should be covered in follow-up monitoring of Drug-resistant TB (DR-TB) patients:

Because of the risk for potential drug-drug interactions, the following medications are not allowed during the 24-week administration of Bedaquiline (Bdq) and up to one month after the last dose of Bdq:

Drug dose administration for shorter/ longer oral Bedaquiline (Bdq)-containing Multidrug-resistant (MDR)/ Rifampicin-resistant (RR)-TB regimen depends on the factors described below.

There are certain inclusion and exclusion criteria for the use of Bedaquiline (Bdq) in TB treatment.

Inclusion Criteria

• Adults and children aged 5 years to less than 18 years of age and weighing at least 15 kg, given their special needs, in consultation with a paediatrician.
• Patients with controlled stable arrhythmia can be considered after obtaining cardiac consultation.
• Pregnant & lactating women (with necessary precautions). ​

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Exclusion Criteria​

To expand access to the Programmatic Management of Drug-resistant TB (PMDT) services, including new regimens and new drugs like Bedaquiline, Delamanid for patients seeking care in the private sector, the following mechanisms are applicable:

Programmatic Management of Drug-resistant TB (PMDT) services for patients seeking care in the private/ other sectors can be accessed from the National TB Elimination Programme (NTEP) at all levels of the health system. 

• This includes care offered from the field level, through the network of Health and Wellness Centres (HWCs) under Ayushman Bharat, to tertiary care available in medical colleges/ nodal DR-TB centres and national-level institutions.

Access to New Regimens to Patients Seeking Care in Private/Other Sectors