ANTIMYCOBACTERIALS

ARJO SURJANTO
SCHOL OF NURSERY
BANDUNG POLYTECHNIC OF HEALTH
 INTRODUCTION
Mycobacterium infection might with or
without symptoms
This study included application of
medicines in tuberculosis, clinical infection
of atypical mycobacterium, and leprosy
After several years decrease,
mycobacterium infection incidence
appears come up, even less close
connection of AIDS epidemic
 TUBERCULOSIS MEDICINE APPLICATION

Streptomycine is firs antimicrobe that shows its activity to fight tubercle

bacteria.
This medicine is still an important medicine in severe tbc management,
but rarely used to initial therapy. The first line are isoniazide, rifampicine,
ethambutol, and pyrazinamide, while streptomycine as alternative drug.
The main problem appeared in tbc and related infection medication is its
trend to become chronic, but might be hyper acute increase and lethal
complicated. Mycobacterium organism usually be intercellular inactive
metabolic for a long time, and inclined resistance to all medicines
In order to slowed the rapid of resistance, combination of first line is used.
When mycobacterium organism is sensitive to medicines clients would
free of infection during 2 3 weeks. While 18 24 month would required
on meningitis tbc or tbc milier. By the way, effective drug regime should
make shorter medication of lung tbc. The effective combination of INH
ethambutol rifampicine make shorter medication of lung tbc infection up
to 6 9 month.
 ISONIAZIDE (1)
INH or isoniazide introduced in 1953 as most active medicine on tbc
therapy
INH has activity intra as good as extra cellular it could work inter
or outer cell of mycobacterium. In vitro, INH inhibit almost all
tubercle bacillus in concentration 0.2 ug/ml or less, and bactericide
to active tubercle bacillus
INH act as bacteriostatic. Its activity is less for many mycobacterium,
it only active to Mycobacterium kansasii
Resistance of INH is right appear when mono medicine is applied.
INH rapid absorbed from intestine. Administration in usual dose (5
mg/kg BW/day) produce peak plasma concentration on 3 5 ug/ml in
1 2 hours. INH right diffuse in body liquids and tissues. Its
concentration on CNS and cerebrospinal liquid is about 20% blood
level.
INH mainly excreted into urine, a large part of it in whole medicine,
other part in acethylation, and others in other conjugation form
 CHEMICAL STRUCTURE

N N

CONHNH2 CH2OH

Isoniazide Pyridoxine

Isoniazide is isonicotinic hydrazide acid (INH). Its

chemical structur is resemble to pyridoxine
 ISONIAZIDE (2)
INH might be most applied medicine to
eradicate KP. This medicine is applied
together ethambutol, rifampicine, or
streptomycine. Usual dose is 5 mg/kg
BW/day (MD is 300mg/day for adult)
Two times above dose applied to severe
infection