Question
Treatment of multi drug resistance tuberculosis
Q3 3 marks Short Notes ★ ✓
Answer
Multidrug-resistant tuberculosis (MDR-TB) is resistant to at least isoniazid and rifampicin.
Treatment principles
Requires an individualized regimen with at least 4–5 effective second-line drugs, guided by drug-susceptibility testing, given for a prolonged duration (18–24 months in older regimens; newer shorter regimens available)
Drugs used
Fluoroquinolones: Levofloxacin, Moxifloxacin
Second-line injectables: Kanamycin, Amikacin, Capreomycin (largely phased out in newer regimens)
Newer oral agents: Bedaquiline, Linezolid, Clofazimine, Delamanid
Other second-line agents: Cycloserine, Ethionamide, Para-aminosalicylic acid (PAS)
Key points
Directly Observed Treatment (DOT) is essential to ensure adherence
Newer all-oral, shorter regimens (e.g., BPaL — Bedaquiline, Pretomanid, Linezolid) have improved outcomes and reduced treatment duration
1 Quinolones
Other Years Asked
1 Prasad, 40-year-man weighing 60 kg suffering from chronic cough with expectoration and
fever was diagnosed to have cavitary pulmonary tuberculosis.
( 2024 March (Supplementary) (2019 Scheme) Essay · 15 marks 2 Ritu, 40-year-old female with complaints of high fever with chills. On asking, she revealed
dysuria, urgency etc. A diagnosis of Acute lower urinary tract infection was made.
( 2023 July (Supplementary) (2019 Scheme) Essay · 15 marks 3 A 30-year-old male patient with history of productive cough, evening rise of temperature
and weight loss since 1 month visits a physician in a tertiary care hospital. On
investigation, patient was positive for acid fast bacilli in the sputum and a diagnosis of
pulmonary tuberculosis was made.
( 2023 January (Supplementary) (2019 Scheme) Essay · 11 marks 4 ( 2023 January (Supplementary) (2019 Scheme) Short Essay · 8 marks 5 Classify fluoroquinolones. Explain the mechanism of action, uses and adverse effects
of fluoroquinolones. (2+1+2+1) 2020 February (Supplementary) (2010 Scheme) Essay · 6 marks 6 Classify drugs used in the treatment of Tuberculosis. Outline the mechanism of
action, adverse effects and uses of Rifampicin. (2+4) 2025 August (Supplementary) (2010 Scheme) Essay · 6 marks 7 A 20 years old pregnant women developed a mild bacterial upper respiratory tract
infection. She was given cap. tetracycline 250 mg thrice daily for 3 days. Answer the
following questions: 2017 August (Supplementary) (2010 Scheme) Essay · 6 marks 8 Enumerate the second generation fluoroquinolones. What is their mechanism of
action. What are the adverse effects produced by them. (2+2+2) 2022 October (Supplementary) (2010 Scheme) Essay · 6 marks 9 Read the clinical problem and answer the following questions. A 20 years old pregnant woman
developed a mild upper respiratory tract infection .She was given cap. Tetracycline 250mg thrice
daily for three days. 2013 September (Supplementary) (2010 Scheme) Essay · 6 marks 10 Discuss in detail about FOUR pharmacokinetic drug interactions with suitable examples. 2025 March (Supplementary (SAY)) (2019 Scheme) Short Essay · 6 marks 11 Classification of fluoroquinolones .Describe the mechanism of action, therapeutic uses and
adverse effects of sparfloxacin. (2 + 2+ 2 =6) 2014 September (Supplementary) (2010 Scheme) Essay · 6 marks 12 Classify the drugs used in Chemotherapy of Tuberculosis. Write the mechanism of
action, therapeutic uses and adverse effects of Rifampicin (3+3) 2025 March (Supplementary) (2010 Scheme) Essay · 6 marks 13 A 40 years old female patient admitted to hospital with a complaint of fever with chills
and right loin pain since 5 days. She is a known diabetic. Urine microscopy shows
plenty of pus cells and gram negative bacilli. Her serum creatinine is moderately
elevated. Ultra sonogram of abdomen suggestive of acute pyelonephritis of right
kidney. 2022 May (Supplementary) (2010 Scheme) Essay · 6 marks 14 A 24-year-old female with fever and chills came to causality. Gives history of
urinary urgency and dysuria. Urine examination confirmed acute lower urinary
tract infection and urine sample given for culture and sensitivity.
( 2023 July (Supplementary) (2010 Scheme) Essay · 6 marks 15 Ciprofloxacin 2024 March (Supplementary) (2019 Scheme) Short Answer · 4 marks 16 Ciprofloxacin 2013 April (2010 Scheme) Short Note · 3 marks 17 Ciprofloxacin 2024 August (Supplementary) (2010 Scheme) Short Note · 3 marks 18 Ciprofloxacin 2018 February (2010 Scheme) Short Note · 3 marks 19 Gatifloxacin. 2015 September (Supplementary) (2010 Scheme) Short Note · 3 marks 20 Ofloxacin 2021 May (Supplementary) (2010 Scheme) Short Note · 3 marks 21 Non systemic antacids 2016 October (Supplementary) (2010 Scheme) Short Note · 3 marks 22 Ciprofloxacin 2025 August (Supplementary) (2010 Scheme) Short Answer · 1 mark 23 Ciprofloxacin 2023 March (Supplementary) (2010 Scheme) Short Answer · 1 mark 24 Mechanism of action of ciprofloxacin 2015 February (2010 Scheme) Short Answer · 1 mark 25 Fluoroquinolones 2014 March (2010 Scheme) Short Answer · 1 mark 26 The antibiotics known to target bacterial protein synthesis are: 2025 March (Supplementary (SAY)) (2019 Scheme) MCQ (Multi) · 1 mark 27 Assertion (A): Penicillin G is a broad-spectrum antibiotic.
Reason (R): Broad-spectrum antibiotics are known to cause superinfections. 2024 December (Supplementary) (2019 Scheme) MCQ · 1 mark 28 Fluroquinolones. 2025 March (Supplementary) (2010 Scheme) Short Answer · 1 mark 29 Amoxicillin in urinary tract infection in pregnancy
Name the following (Two examples for each) (5x1=5) 2019 February (2010 Scheme) Short Answer · 0.3 marks 30 Drugs used for typhoid fever 2024 June (Supplementary) (2019 Scheme) Short Answer · 0.2 marks 31 Amikacin in gonorrhoea
Name the following (Two examples for each): (8x1=8) 2022 February (2019 Scheme) Short Answer · 0.2 marks 32 Drugs active against pseudomonas infection 2022 July (Supplementary) (2019 Scheme) Short Answer · 0.2 marks 
