Binds to the β subunit of DNA-dependent RNA polymerase, thereby blocking production of RNA.

Must be administered with isoniazid or other anti-TB drugs to prevent drug resistant mycobacteria

Red color in body fluids - orange urine & secretions (sweat, tears); thrombocytopenia, nephritis, cholestatic jaundice, hepatitis, proteinuria, flu-like syndrome

Strongly induces P450, which increases the elimination of numerous other drugs

1^st line agent for TB; atypical mycobacterial infections; eradication of meningococcal colonization; staphylococcal infections (osteomyelitis, prosthetic valve endocarditis)

Inhibits synthesis of mycolic acids, which are essential components of mycobacterial cell walls.

Fever, skin rashes, Lupus, hepatic toxicity (esp. alcoholics), peripheral neuropathy (esp. w. malnutrition, alcoholism, diabetes, AIDS, uremia), CNS (memory loss, psychosis, seizures); optic neuritis

1^st line agent for TB; treatment for latent infection; less active against other mycobacteria

Taken up by macrophages and works (by an unknown mechanism) against

mycobacteria residing within the acidic environment of lysosomes.

hepatotoxicity, hyperuricemia, nausea, vomiting, drug fever, acute gouty arthritis

“Sterilizing” agent used during the first 2 months of therapy, allows total duration of therapy to be shortened to 6 months

Inhibits mycobacterial arabinosyl transferases, which are involved in the polymerization reaction of arabinoglycan, an essential component of the mycobacterial cell wall.

Optic neuritis = retrobulbar neuritis (loss of visual acuity, red-green color blindness)

Given as 4 drug initial combination therapy for TB until drug sensitivities are known; also used for atypical mycobacterial infections

Aminoglycoside (See CH 45); Prevents bacterial protein synthesis by binding to the S12 protein of the 30S ribosomal subunit

Penetrates cells poorly, so is active mainly against extracellular tubercle bacilli. Crosses the BBB and can deal with inflamed meninges.

Ototoxicity, nephrotoxic, vertigo

Renal damage/renal failure

Used in TB when an injectable drug is needed or desirable and in treatment of drug-resistant strains

Inhibits folate synthesis (like sulfonamides)

Hemolytic anemia, methemoglobinemia, erythema nodosum leprosum, fever, pruritis, GI intolerance

Leprosy (Mycobacterium leprae)