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Antituberculous drugs: An overview

Richard H Drew, PharmD, MS, FCCP, FIDP
Timothy R Sterling, MD
Section Editor
C Fordham von Reyn, MD
Deputy Editor
Elinor L Baron, MD, DTMH


Pharmacologic agents for treatment of tuberculosis (TB) are utilized in a hierarchical fashion [1-4]. First-line agents for treatment of active tuberculosis consist of isoniazid, a rifamycin (rifampin or [less frequently] either rifapentine or rifabutin), pyrazinamide, and ethambutol. Presence of drug resistance, contraindication, or intolerance to first-line agents may warrant substitution with one or more second-line agents. Categories of second-line agents include fluoroquinolones, injectable agents (such as aminoglycosides and capreomycin), other core second-line agents, and add-on second-line agents (table 1). Dosing for first- and second-line agents is summarized in the tables (table 2 and table 3).

Pharmacologic issues and some clinical data related to use of antituberculous drugs are reviewed here; issues related to clinical use of antituberculous drugs in therapeutic regimens are discussed separately. (See "Treatment of drug-susceptible pulmonary tuberculosis in HIV-uninfected adults" and "Treatment of pulmonary tuberculosis in HIV-infected adults" and "Treatment of drug-resistant pulmonary tuberculosis in adults".)


First-line antituberculous agents for treatment of susceptible TB consist of isoniazid, a rifamycin (usually rifampin), ethambutol, and pyrazinamide. The clinical approach to use of these agents is discussed separately. (See "Treatment of drug-susceptible pulmonary tuberculosis in HIV-uninfected adults" and "Treatment of pulmonary tuberculosis in HIV-infected adults".)

Dosing for first-line agents is summarized in the tables (table 2 and table 4 and table 5).

Issues related to isoniazid are discussed further separately. (See "Isoniazid: An overview" and "Isoniazid hepatotoxicity" and "Isoniazid (INH) poisoning".)

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Literature review current through: Sep 2017. | This topic last updated: Aug 15, 2017.
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