In the presence of inhA mutations, significant cross-resistance between INH and ethionamide
has been observed.
AMK, amikacin, amikacin; CAP, capreomycin; CIP, ciprofloxacin; CYS, cycloserine; EMB, ethambutol; ETH, ethionamide
; KAN, kanamycin; LVX, levofloxacin; MXF, moxifloxacin; OFX, ofloxacin; PAS, para-aminosalicylic acid; PTH, prothionamide; PZA, pyrazinamide; STR, streptomycin; TRZ, terizidone.
In doses of 5 to 100 mg/kg of body weight, caraway extract has been found to be a highly efficacious bioenhancer, boosting the potency of cycloserine by 75%, of rifampicin by 110%, and of ethionamide
However, higher adverse events were recorded with ethionamide
and pyrazinamide while fluoroquinolones had minimal toxicity.
Capreomycin (2.5 [micro]g/mL), cycloserine (70 [micro]g/mL), ethionamide
(2.5 [micro]g/mL), kanamycin (2.5 [micro]g/mL) and ciprofloxacin (1 [micro]g/mL).
In both these cases, Ethionamide
was replaced by PAS.
The following regimen is used for MDRTB treatment: Kanamycin or Capreomycin, Levofloxacin, Cycloserine, Ethionamide
, Pyrazinamide, and Ethambutol.
Final susceptibility results demonstrated resistance to isoniazid, rifampicin, rifabutin, clofazimine, and streptomycin with sensitivity to ethambutol, pyrazinamide, amikacin, capreomycin, ciprofloxacin, cycloserine, and ethionamide
. The regimen was continued without rifabutin.
Patient was a known case of multidrug resistant tuberculosis and was being treated with the following drugs for two months: amoxicillin-clavulanate, ethionamide
, intramuscular capreomycin, linezolid, and para-aminosalicylate (PAS) granules.
Considering the patient previous treatment schemes, and based on expert's opinion, after normalization of liver enzymes, a slower reintroduction of second-line drugs was made: starting with levofloxacin 750 mg/day and amikacin 750 mg/day, twenty days later adding ethionamide
500 mg/ day and 27 days later adding cycloserine 500 mg/day.
The second-line drugs are kanamycin, ciprofloxacin, ethionamide
, and so on.
The pyridine nucleus is also a constituent of many structurally simple drugs such as ethionamide
and isoniazid, both these drugs are important prodrugs for enoyl-acyl carrier protein reductase used in the treatment of tuberculosis, bupicomide used as dopamine, b-hydroxylase inhibitor in the treatment of hypertension and amrinone used as phosphodiesterase 3 inhibitor in the treatment of heart failure (Fig.