In the ongoing battle against tuberculosis (TB), which is still a major worldwide health concern, the development of potent antituberculosis drugs has proven essential. With the intention of eliminating the infection and stopping its spread, these medications specifically target Mycobacterium tuberculosis, the bacteria that causes tuberculosis. The following are important categories of antituberculosis drugs: Agents in the First Line: A key component of TB treatment, isoniazid (INH) is used to treat both latent and active tuberculosis infections. Mycolic acid production is a necessary component of the mycobacterial cell wall, and INH inhibits it. It is possible to become resistant to INH, frequently in conjunction with other medication resistance. Rifampin: By attaching to the beta subunit of RNA polymerase, rifampin, another crucial first-line medication, prevents the synthesis of RNA in bacteria. When used in combination therapy, this bactericidal activity helps stop the emergence of resistance. Pyrazinamide: Although the precise mode of action of this medication is unknown, it is thought to function well in the acidic macrophage milieu in which M. tuberculosis is found. Pyrazinamide works especially well against bacilli that are dormant. Ethambutol: By interfering with arabinosyl transferases, it prevents the mycobacterial cell wall from synthesizing arabinogalactan. When taken in combination therapy, it is less effective than INH or rifampin, although it is still very important in preventing resistance. Agents on the Second Line: Fluoroquinolones, such as moxifloxacin, are medicines that block DNA gyrase, an enzyme that is necessary for DNA replication in bacteria. When first-line medications are not working or resistance exists, they are used. Medications administered by injection, such as amikacin and kanamycin, are only used for instances of tuberculosis that are resistant to many drugs. They prevent the bacteria from synthesizing proteins. Linezolid: Linezolid, which was first created to treat Gram-positive infections, binds to the 50S ribosomal subunit and prevents the synthesis of proteins. When all other treatments fail, it is used for extensively drug-resistant tuberculosis (XDR-TB). New Agents: Bedaquiline: A more recent drug that interferes with the synthesis of energy by mycobacterial ATP synthase is bedaquiline. It is an essential component of the toolkit for treating TB that is resistant to multiple drugs. Delamanid : Like INH, this nitroimidazole derivative prevents the formation of mycolic acid. It treats multidrug-resistant tuberculosis, frequently in conjunction with other medications. To stop resistance from developing and boost treatment success rates, effective TB treatment frequently combines these drugs. Research is still being done on creating novel medications with distinct modes of action to counteract the growth of drug-resistant forms of tuberculosis as the landscape of therapy for the disease changes.
