antibioticsbooks

Pyrazinamide
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Agent: pyrazinamide
Pyrazinamide is a first-line drug for the treatment
of tuberculosis. It is part of the initial four-drug
regimen to shorten the overall duration of therapy
from nine months to six months. Pyrazinamide has
bactericidal activity against even slow-growing
M. tuberculosis. It is generally used only in the
first two months of tuberculosis therapy.
Mechanism of Action
Pyrazinamide is a prodrug with an unclear mechanism
of action. In its active forms it is thought to
prevent the production of mycolic acids by inhibiting
the enzyme fatty acid synthetase I, though it
likely has other effects as well.
Spectrum
Active only against M. tuberculosis.
Adverse Effects
The key adverse effects for pyrazinamide are
hyperuricemia and hepatotoxicity. Hepatotoxicity
(chiefly hepatitis) is dose-dependent and less common
at the lower doses given today than the higher
ones previously used. Hyperuricemia is predictable