BACKGROUND Paediatric drug resistant (DR) tuberculosis (TB) continues to be a mammoth challenge and there is limited literature available to shed light on this. To study the clinical profile and outcome of paediatric DRTB in India under the programmatic settings. MATERIALS AND METHODS We conducted retrospective observational study to analyse the clinical profile and treatment outcome of DRTB in paediatric population. Data of patients aged below 18 years enrolled at programmatic management of

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... B register, from July-2013 to oct-2014 was reviewed to record demographic details, resistance pattern, management and outcome. Quantitative data was analysed using mean and percentages. RESULTS Out of 120 patients, 95% (114) were above 12 years and rest 5% (6) were below 12 years, male to female ratio was 1:2.53. MDR-TB was present in 85% (102), 9.17% (11) had pre-XDR-TB, 5.83% (7) had XDR-TB. Pulmonary-DRTB was seen in 89.17% (105), 10.83% (15) had extrapulmonary-DRTB. Primary-DRTB was observed in 11.67% ( 14 ). Complications noted were pneumothorax (5.83%, 7 cases) and haemoptysis (2.5%, 3 cases). Mean duration of culture conversion was 3.33 months. Commonest adverse drug reactions (ADRs) were Psychosis, gastritis (11.67%, 14 cases each). Overall treatment success was 42.5% (51) which was better in MDR-TB (44.11%, 45 cases) than XDR-TB (28.5%, 2 cases) and Pre-XDR-TB (36.36%, 4 cases). Mortality was 21.67% (26) of whom 19.60% (20) had MDR-TB, 42.8% (3) had XDR-TB, 27.27% (3) had pre-XDR-TB and 20% (24) failed to treatment. CONCLUSION Optimistic results can be achieved by early diagnosis, meticulous counseling, legitimate follow ups and management of ADRs even under programmatic conditions with varying resources.