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Resistance to antimycobacterial
• Mycobacteria will grow slowly in a near dormant state and little metabolic activity. Therefore, the
conventional * targets are not suitable. Current tax regimens have been constituted to * in high
cure rates since combination therapy is used. it ensures that there will be an unlikely chance if a
spontaneous resistant isolate to all agents.
• Problems occur when pts receive inadequate therapy which provides a serious selection
advantage. Resistance can thus occur to single agents or multiple agents.
Agents used
Isoniazid
• Bactericidal; reduces the pH of aerobically organisms.
Pyrazinamide
• Bactericidal; active at low pH; useful in killing M.os within the necrotic foci early infection but it is
less useful later on when the foci reduce in #.
Rifampicin
• Targets slow growing M.os
Resistance
Rifampicin
• Resistance is due to mutation in the B-sub unit of RNA polymerase
Isoniazid
• Due to * of catalase gene which results in reduced or absence of
catalase * . Catalase activity is absolute requirement 4 conversion of
INH to hydrazine derivative.
Pyrazinamide
• A * . Requires pyrazinamide to produce the active pyrazinoic acid.
Resistance is mainly due to mutation in the pyrazinamidase gene.
Streptomycin
• * of resistance meaning there are other resistance mechanisms that
may be involved.
Ethambutol
• Due to missense mutations in the gene that encodes 4 the gene
arabinosyl transferase which is a target for ethambutol.
Multiple Drug Resistance
• It is whereby previously susceptible bacteria become resistance to
multiple antibiotics through acqu...