- inhibit synthesis of mycolic acid (cell wall)
- selective for mycobacterium
- mechanism of action : Inhibit enoyl-CoA reductase of fatty acid synthase and formation of covalent complex with carrier protein
Rifampicin (R)
- broad spectrum
- mechanism of action :bind to Beta subunit of bacterial-DNA-dependent RNA polymerase
Pyrazinamide (Z)
- never used on its own
- mechanism of action : TB has pyrazinamidase (an enzyme). Convert pyrazinamide to pyrazinoica cid. Pyrazinoic acid inhibits fatty acid synthesis of TB
Streptomycin (S)
- aminoglycoside
- mechanism of action : causing misreading and inhibition of protein synthesis on bacterial ribosomes
Ethambutol (E)
- anabinoglycan is a component of mycobacterial cell wall
- mechanism of action : inhibit mycobacterial arabinosyl transferase involve in polymerization of arabinogalactan
Combinations :
Initial / intensive phase : HRZ, HRZS or HRZE
Maintenance phase : HR
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