Pyrazinamide is a medication used to treat tuberculosis.[1] For active tuberculosis, it is often used with rifampicin, isoniazid, and either streptomycin or ethambutol.[2] It is not generally recommended for the treatment of latent tuberculosis.[1] See also Pyrazinamide.
Pyrazinamide diffuses into the granuloma of M. tuberculosis, where the tuberculosis enzyme pyrazinamidase converts pyrazinamide to the active form pyrazinoic acid.[3] Under acidic conditions of pH 5 to 6, the pyrazinoic acid that slowly leaks out converts to the protonated conjugate acid, which is thought to diffuse easily back into the bacilli and accumulate. The net effect is that more pyrazinoic acid accumulates inside the bacillus at acid pH than at neutral pH.[3][4]
