Multidrug Resistant Tuberculosis; a Pharmacological view based on Revised National Tuberculosis Control Programme DOTS-Plus Guidelines

–Directly Observed Therapy Strategy (DOTS) -Plus is a part of DOTS program that adds approach for multidrug resistance tuberculosis (MDR-TB) diagnosis, management, and treatment. WHO approved DOTS-Plus program began in 2000 and was established to encourage access to high quality second line drugs for appropriate use in MDR-TB control programs. The top priority is to prevent the emergence of MDR-TB by ensuring a low default rate of cases treated with first-line anti-TB drugs. If MDR-TB has emerged in a certain area, it should be treated in addition to improving the basic treatment. In this situation, accurate and reliable drug susceptibility testing, methods to support patients in order to ensure direct observation of complete treatment and the use of maximally effective regimens must be ensured. Second-line drugs should not be held back in patients with MDR-TB rather they have a good chance of cure with it, hence the treatment, if it is to be provided, should be optimally selected and administered. This review is highlighting the pharmacological view point of second line anti tubercular drug incorporated in DOTS-Plus therapy for MDR-TB. Keywords––DOTS-Plus therapy, DOTS, MDR-TB, Adverse drug reactions, Drug resistant