Dr Zarir Udwadia, a tuberculosis specialist at the Hinduja National Hospital in Mumbai, published a paper in the Clinical Infectious Diseases journal late last year documenting four cases of TDR-TB.
told Reuters he
has now identified 12 cases for which he
has all but run out of treatment options.
Three are already dead.
has tested one powerful anti-TB drug after another on samples cultured from these patients - including first-line treatments like isoniazid, rifampicin and streptomycin, and a range of second line drugs like moxifloxacin, kanamycin and ethionamide.
Each medicine failed.
"If you add it all up, they were resistant to 12 drugs in total," he
Like others, Udwadia
blames poor medical practice.
Non-prescription and over-the-counter antibiotic use is rife in India and it may be no coincidence that the country now has one of the highest burdens on MDR-TB in the world, with more than 100,000 cases.
team conducted a recent study in Mumbai, home to more than 12 million people often living in harsh and overcrowded conditions, and found in one district only five out of 106 doctors in the unregulated private sector could give a correct prescription for a hypothetical patient with MDR-TB.
Most of the prescriptions were "inappropriate" and would only have made the patient worse - driving the conversion of MDR tuberculosis to XDR and then to TDR tuberculosis.
The Mumbai findings show that totally drug-resistant TB "was an accident waiting to happen," Udwadia