ANTIMYCOBACTERIALS

Mycobacteria (Mycobacerium
tuberculosis)
Mycobacteria are intrinsically resistant to
most antibiotics.
The organism grows slowly, thus, the
disease may have to be treated for 6 months
to 2 years
Combination drug therapy is the rule to
delay or prevent the emergence of
resistance and to provide additive (possibly
synergistic) effects against Mycobacterium
tuberculosis

DRUG
Isoniazid (INH)

Mechanism Of Action
Inhibits mycolic acid synthesis

Prodrug requiring conversion by catalase

Bacteriostatic- For bacilli in stationary phase
Bactericidal for rapidly dividing organism
Rifampin

Ethambutol

Inhibits DNA-dependent RNA polymerase

(nucleic acid synthesis inhibitor) bactericidal
Inhibits synthesis of arabinogalactan ( cellwall component) -bacteriostatic

Pyrazinamide(PZA) Bactericidal to actively dividing organisms

Streptomycin

Protein Synthesis Inhibitor (See

aminoglycosides)

Recommended Multi-drug schedules

Some characteristics of Antitubercular

drugs

Pharmacokinetics
ISONIAZID

Absorption is
impaired with food (
CHO) or with
aluminum containing
antacids

Pharmacokinetics
RIFAMPIN

urine and tears

may appear redorange in color

Pharmacokinetics
PYRAZINAMIDE AND ETHAMBUTOL

Causes urate
retention and
gouty attacks

drugs for MDR TB

Fluoroquinolones
( Ciprofloxacin and Levofloxacin
For MDR-TB