Anti-Bacterial Agents
Catalase
Isoniazid
Prodrugs
Tuberculosis

Isoniazid

Isoniazid (INH) is an antibiotic indicated in the first-line treatment of active Mycobacterium tuberculosis (TB) infection. INH has been a significant drug in TB treatment regimens for decades. INH functions as a prodrug activated by the catalase-peroxidase KatG, generating various radicals and adducts that inhibit the production of mycolic acids, the essential components of the mycobacterium’s cell wall. This mechanism of action makes INH a potent bactericidal agent. Moreover, INH exhibits synergistic effects with other species generated by KatG and other medications utilized in TB treatment. Mutations in the katG, inhA, kasA, and ahpC genes can lead to resistance against INH therapy. Resistance of M tuberculosis can occur more rapidly with INH monotherapy. This activity reviews the indications, mechanism of action, and contraindications of INH as a valuable agent in treating both active and latent TB infections. This activity also highlights the drug’s adverse event profile, regimens and dosing, and other key factors pertinent to the interprofessional healthcare team when using INH for TB treatment.

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