- Author: Basil Varkey, MD, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP more...
For latent tuberculosis, isoniazid for 9 months, daily or intermittently (twice weekly directly observed treatment [DOT]), is the DOC.
For active tuberculosis, drugs commonly used in treatment include isoniazid, rifampin, pyrazinamide, streptomycin, and ethambutol. Dosages and treatment should follow established expert guidelines.
Active against susceptible strains of M tuberculosis.
Best combination of effectiveness, low cost, and minor adverse effects. First-line drug unless known resistance or another contraindication is present.
For use in combination with at least 1 other antituberculous drug. Inhibits DNA-dependent bacterial, but not mammalian, RNA polymerase. Cross-resistance may occur. Treat for 6-9 mo and at least until 3 mo beyond negative culture results.
Pyrazine analog of nicotinamide that may be bacteriostatic or bactericidal against M tuberculosis, depending on concentration of drug attained at site of infection. Mechanism of action is unknown. This drug should be used only in combination with other antituberculous drugs.
For treatment of susceptible mycobacterial infections. Use in combination with other antituberculous drugs (eg, isoniazid, ethambutol, rifampin).
Diffuses into actively growing mycobacterial cells (eg, tubercle bacilli). Impairs cell metabolism by inhibiting synthesis of one or more metabolites, which in turn causes cell death. No cross-resistance demonstrated. This drug should be used only in combination with other antituberculous drugs.
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