What is the first-line therapy for pulmonary tuberculosis?

The first-line therapy for pulmonary tuberculosis consists of a regimen that includes isoniazid and rifampin, along with other essential medications like pyrazinamide and ethambutol during the initial phase of treatment. Isoniazid works by inhibiting the synthesis of mycolic acids, which are crucial components of the bacterial cell wall, while rifampin acts by inhibiting bacterial RNA polymerase, effectively halting bacterial protein synthesis.

The combination of these two drugs is highly effective and essential for both the rapid sterilization of the lungs and the prevention of resistance development. This multi-drug regimen is critical because it maximizes the bactericidal effect, minimizes the risk of relapse, and reduces the chance of developing drug-resistant strains of Mycobacterium tuberculosis. Utilizing a single drug alone could lead to inadequate treatment and the selection of resistant organisms.

In addition to the efficacy of this combination, it is important to note that the recommended duration of therapy typically spans six months for drug-sensitive pulmonary tuberculosis, although the initial two months generally simultaneous administration of isoniazid and rifampin with other first-line agents is crucial for optimal results.

Other choices may involve medications that can be effective for specific cases or follow-up therapies but do