Chronic granulomatous disease caused
by Mycobacterium tuberculosis.
Tuberculosis typically attacks the
lungs, but can also affect other parts of
It is spread through the air when people
who have an active TB infection
cough, sneeze, or otherwise transmit
respiratory fluids through the air.
Semisynthetic derivative of rifamycin
, am anitibiotic obtained from
Highly effective tuberculocidal
Acts on both intra
It is called a sterilizing
Rifampicin binds to beta subunit of DNA
dependant RNA polymerase and inhibits
RNA synthesis in bacteria.
It cannot bind to human RNA
polymerase, thus selectively destroying
TB & atypical
Analog of nicotinamide
Requires acidic pH for
Mechanism of action
not clearly known.
HEPATOTOXICITY is the
Most common adverse
Acts only against extracellular organisms
Has to be given IM
When used alone
Least preferred first
Also effective against
Well absorbed on oral administration
Dose should be reduced in renal failure
Optic neuritis is an important adverse effect
which needs withdrawal of the drug.
It decreases the renal excretion of uric acid
and enhances plasma urate levels.
INH: potent bactericidal
Rifampicin: potent bactericidal
Pyrazinamide: weak bactericidal
NEVER USE A SINGLE DRUG FOR CHEMOTHERAPY IN
TUBERCULOSIS, A COMBINATION OF 2 OR MORE IS
Used only if organism is resistant to first
Ethionamide , PAS, cycloserine :
Amikacin, capromycin, fluoroquinolones
are used in Multi Drug Resistant TB
1. INH+S+T daily for 2 months
2. INH+T daily for 10 months
INH – isoniazid
S – Streptomycin
T - Thiacetazone
1. INH+R+Z+E/S daily or thrice a week for 2
months followed by:
2. INH+R daily or thrice a week for 4
3. INH+R+Z trice a week for 2 months
4. INH+R daily for 7 months.