According to DOTS-PLUS guidelines 2013 treatment of multidrug resistance TB includes all except ?
**Core Concept**
The DOTS-PLUS (Directly Observed Treatment, Short-Course Plus) guidelines aim to address multidrug-resistant tuberculosis (MDR-TB) by providing a standardized treatment protocol. This concept revolves around the pharmacological management of MDR-TB, emphasizing the use of second-line drugs to combat drug-resistant strains.
**Why the Correct Answer is Right**
MDR-TB treatment under DOTS-PLUS guidelines involves the use of a combination of drugs, including injectable agents (e.g., amikacin, kanamycin), oral fluoroquinolones (e.g., moxifloxacin), and second-line injectable agents (e.g., capreomycin). These drugs aim to target and inhibit the growth of M. tuberculosis in patients with drug-resistant strains. The primary goal is to achieve bacteriological cure while minimizing the development of further resistance.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it is a part of the DOTS-PLUS protocol for treating MDR-TB. The use of injectable agents like amikacin is a cornerstone of MDR-TB treatment.
**Option B:** This option is incorrect because it is not a recommended treatment for MDR-TB according to the DOTS-PLUS guidelines. While it may be used in other contexts, it is not a standard component of MDR-TB treatment.
**Option C:** This option is incorrect because it is not a part of the DOTS-PLUS protocol for treating MDR-TB. The use of oral fluoroquinolones like moxifloxacin is a recommended treatment option for MDR-TB.
**Clinical Pearl / High-Yield Fact**
It is essential to note that treatment adherence and patient monitoring are crucial components of MDR-TB management. Regular assessment of treatment response and side effects is vital to prevent the development of further resistance and ensure effective treatment outcomes.
**Correct Answer: B.**