Title:An Experience with Delamanid in an XDR TB Case – Case Report
Volume: 21
Issue: 4
Author(s): Nimitha Mohan, Manharpreet Kaur, Lipika Singhal*, Varinder Saini and Jagdish Chander
Affiliation:
- Department of Pulmonary Medicine, Government Medical College Hospital-32, Sector 32, Chandigarh,India
Keywords:
XDR-TB, drug defaulter, delamanid, cure of TB, methoxy-mycolic, MDR-TB.
Abstract:
Introduction: Tuberculosis is an endemic infection and a serious public health problem
in India. India constitutes one-fourth of the global TB population. The emerging drug resistance is
a major threat to global tuberculosis care and control.
Case report: We present a case of newly diagnosed microbiologically confirmed, extremely drugresistant
primary pulmonary tuberculosis which was treated with Delamanid and was found to be
cured of tuberculosis.
Discussion: Delamanid is a new anti-tubercular drug, which is thought to primarily inhibit the synthesis
of methoxy-mycolic, and keto-mycolic acid, which are components of the mycobacterial cell
wall. In our patient who was a newly diagnosed case of MDR-TB converted to XDR-TB in little
course of time and we were successful in treating him with Delamanid therapy. His sputum culture
conversion was achieved in 20 days. Even though the patient did not tolerate well because of the
side effects of the drug, still he became microbiologically negative for tuberculosis.
Conclusion: Delamanid fulfills many target criteria for new TB drugs and may be particularly useful
for the treatment of MDR-TB. It can be administered orally and its bactericidal properties make
it suitable in regimens designed to shorten treatment duration. Clinical efficacy data, while limited,
are reassuring.