Tuberculosis Treatment: Understanding the Mechanisms of Drug Action

Tuberculosis treatment requires a combination of various anti-tuberculosis drugs in a specific regimen. This is based on the different characteristics and locations of Mycobacterium tuberculosis, resulting in varying drug resistance.

Classification of Mycobacterium tuberculosis:

• Group A (Extracellular): Located in the cavity wall of the tubercle, with sufficient oxygen, alkaline pH, leading to rapid growth and a large number of bacteria. Group A is killed by rifampicin, isoniazid, and streptomycin.

• Group B (Extracellular): Found deeper in the cavity wall, with an alkaline environment, low pressure, resulting in slow growth and a smaller number than Group A. Group B is killed by rifampicin, isoniazid has less effect, and streptomycin has no effect.

• Group C (Intracellular): Located inside cells, with an acidic environment, leading to very slow growth. Group C is killed by pyrazinamide (strong effect in acidic environment), rifampicin (some effect), isoniazid (some effect), and streptomycin (no effect).

• Group D (Dormant): Mycobacterium tuberculosis in a dormant state, the body’s immune system can eliminate them.

Relapse of tuberculosis is often due to the existence of Group B and Group C.

Classification of anti-tuberculosis drugs:

• Bactericidal drugs: Kill Mycobacterium tuberculosis under normal conditions. Includes isoniazid and streptomycin.

• Bacteriostatic drugs: Prevent the growth of Mycobacterium tuberculosis. Includes rifampicin and pyrazinamide.

• Bacteriostatic drugs: Slow down the growth rate of Mycobacterium tuberculosis. Includes ethambutol, thiacetazon, and PAS.

Note: The use of anti-tuberculosis drugs must follow the doctor’s prescription, using the full dosage, duration, and according to the regimen to achieve optimal treatment efficacy and prevent drug resistance.