## Understanding NTEP Guidelines and Drug Regimens ### Correct Statements (Options 0, 1, 2) **Key Point:** The NTEP (formerly RNTCP) aims for TB elimination by 2025 as per India's National Strategic Plan 2017–2025. **High-Yield:** Standard drug-susceptible TB treatment follows the WHO-endorsed regimen: - **Intensive phase:** 2 months (HRZE — isoniazid, rifampicin, pyrazinamide, ethambutol) - **Continuation phase:** 4 months (HR — isoniazid, rifampicin) - Total duration: 6 months **Clinical Pearl:** The Pradhan Mantri TB Mukt Bharat Scheme provides nutritional support of ₹500 per month to all TB patients to improve treatment outcomes and adherence. ### Why Option 3 is INCORRECT **Warning:** Bedaquiline is a **second-line agent**, NOT a first-line agent. It is reserved for: - Drug-resistant TB (MDR-TB, XDR-TB) - Patients with documented resistance to first-line drugs - NOT used in routine drug-susceptible TB Isoniazid remains a cornerstone of first-line TB therapy and is used in all drug-susceptible TB regimens. Bedaquiline is never preferred over isoniazid in standard TB treatment — it is an addition to regimens when resistance is present. ### Classification of TB Drugs | Category | Agents | Role | |----------|--------|------| | **First-line** | HRZE (intensive), HR (continuation) | All drug-susceptible TB | | **Second-line (Group A)** | Bedaquiline, linezolid, levofloxacin | MDR-TB, XDR-TB | | **Second-line (Group B)** | Cycloserine, terizidone, para-aminosalicylic acid | Adjunctive in resistant TB | [cite:Park 26e Ch 8] --- ## Summary **Key Point:** Bedaquiline is a second-line agent for drug-resistant TB only, not a first-line replacement for isoniazid in routine TB management.
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