Rats were treated with PZA
at a dose of 1 ml/kg of 500 mg/kg PZA
in saline over 4 weeks which was reported as a hepatotoxic dose in previous study histologically,  and when animals were treated with pyrazinamide, the extensive necrosis of liver paranchymal cells and inflammatory cells infiltration was occurred [Figure 1].
is a prodrug requiring pyrazinamidase (PZase) mediated conversion to pyrazinoic acid (POA).
Many studies have demonstrated a high prevalence of PZA
resistance among MDR-TB patients in different localities, ranging from 10% in Papua New Guinea and 25% in Turkey, to 49% in Thailand, 50% in Central Africa, 52% in South Africa, 53% in Japan, 55% in Taiwan, 77% in Pakistan and 85% in South Korea and in India (7).
Basification of PZA
4 to Dianionic Polyelectrolyte (DAPE) 6.
may induce both dose-dependent and idiosyncratic hepatotoxicity.
kills dormant persister bacteria and plays a critical role in shortening TB therapy.
Another method used for detection of PZA
susceptibility is pyrazinamidase (PZase) activity test.
If, as usually happens, PZA
and ETH are subsequently included in the second-line regimen to manage first-line failures or MDR-TB, the chances of developing further resistance to the other second-line drugs such as streptomycin (SM) are greatly magnified.
No more than a 2-weeks supply of RIF-PZA (with a PZA
dose [less than or equal to]20 mg/kg/d and a maximum of 2 gm/d) should be dispensed at a time to facilitate periodic clinical assessments.
Although the authors of the reports worked separately, their research meshes well because isoniazid and PZA
, while very different, have a common feature.
CIP, ciprofloxacin; CLR, clarithromycin; EMB, ethambutol; INH, isoniazid; MX, moxifloxacin; PZA
, pyrazinamide; RFP, rifampin.