Pretomanid is a new type of anti tuberculosis drug, which has shown significant effect on drug-resistant tuberculosis.

1. Basic characteristics of drugs

(1) Nitroimidazole antibiotics exert their effects by inhibiting the synthesis of cell walls in mycobacteria.

(2) Developed for multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB).

(3) In 2019, it received accelerated approval from the FDA and was listed on the WHO Essential Medicines List.

2 Clinical efficacy data

(1) When combined with bedaquiline and linezolid, the cure rate reaches 89%.

(2) The treatment cycle can be shortened to 6 months (traditional methods require 18-24 months).

(3) Effective for both pulmonary and extrapulmonary tuberculosis, including HIV co infected individuals.

3 Applicable Population

(1) Drug resistant tuberculosis: applicable to the treatment of multi drug resistant tuberculosis (MDR-TB) or extensively drug resistant tuberculosis (XDR-TB) in adult patients.

(2) Combination therapy: It needs to be used in combination with bedaquiline and linezolid to form the BPaL regimen.

4 Forbidden Groups

(1) Pregnancy period: Animal studies have shown embryotoxicity, and pregnant women should avoid using contraception. Women of childbearing age should take contraceptive measures during treatment and after discontinuing medication.

(2) Breastfeeding period: Medications may be secreted through breast milk. Breastfeeding is prohibited during treatment and after the last administration.

(3) Liver function impairment: Patients with severe liver dysfunction should use caution and closely monitor liver function indicators.

5 Special Precautions

(1) Liver function monitoring: Regular monitoring of liver function is required during treatment, and any abnormalities should be promptly adjusted in dosage or discontinued.

(2) Drug interactions: Caution should be exercised when combined with strong CYP3A4 inducers or inhibitors as it may affect drug concentration.

(3) Adverse reaction management: Common adverse reactions include peripheral neuropathy, liver dysfunction, etc., which need to be treated in a timely manner.