Which among the following is the MOST effective antitubercular drug against slow multiplying intracellular mycobacteria?
Rifampicin is bactericidal for mycobacteria, it can penetrate into most tissues and phagocytic cells. It has the capacity to kill intracellular organisms and those sequestered in abscesses and lung cavities. Rifampicin acts by binding to the beta subunit of bacterial DNA-dependent RNA polymerase and thereby inhibiting RNA synthesis. It is well absorbed after oral administration and is excreted mainly through the liver into bile. It then undergoes enterohepatic recirculation, with the bulk excreted as a deacylated metabolite in feces and a small amount excreted in the urine. Indications: Along with other antituberculous drugs, it is used against mycobacterial infections Used to eliminate meningococcal carriage As prophylaxis in contacts of children with Haemophilus influenzae type b disease To eradicate staphylococcal carriage In serious staphylococcal infections such as osteomyelitis and prosthetic valve endocarditis Ref: Deck D.H., Winston L.G. (2012). Chapter 47. Antimycobacterial Drugs. In B.G. Katzung, S.B. Masters, A.J. Trevor (Eds), Basic & Clinical Pharmacology, 12e
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol