An Experience with Delamanid in an XDR TB Case – Case Report

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.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.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.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.