RESULTS: Out of 308 patients enrolled for study 67% were males and majority (79%) were of age group 18-45 years. Among Study participants, 97% had Pulmonary DR- TB, out of them 11.7% had Primary while 88.3% had Acquired Drug Resistance. Among Study participants various comorbid condition were present among which Diabetes, HIV-AIDS & Hypertension were more common. Radiological findings showed 74% of Pulmonary DR-TB patients having bilateral lesion, 56% of the lesions were cavitatory and 60% of patients had moderately advanced disease. At the End of 1 year, 231 chest radiographs were available for comparison. Positive response was noted among 183 radiographs with 181 of these having simultaneous favourable bacteriological response suggesting strong correlation (p<0.001). Sputum culture conversion at different time intervals was seen among 80.6% of patients with a mean duration of 4.06 ±0.95 months. At the end of 1 year of Cat-IV regimen treatment, 209 cases had favourable bacteriological response while 22 had poor bacteriological response, 27 died and 41 defaulted the treatment. Minor ADR were present in 81% (249) of the patients among which nausea, vomiting and arthralgia were more common while rest 39% (120) patients experienced major ADR like hypokalemia which were life threatening and demanded withdrawal of offending drug.