Action of Ethambutol

From the discussion above is it clear that both AG and LAM play paramount roles in the infection and survival of mycobacteria in the host. Drugs that act by inhibiting the biosynthesis of these polysaccharides are expected to show antimycobacterial action. One of the commonly used antituberculosis agents, ethambutol [(5,5')-2,2'-(ethylenediimino)di-1-butanol, 22] (Fig. 7), has been used for the treatment of tuberculosis since 1961, when it was first reported to have antimycobacterial activity

Figure 7 Structure of the antituberculosis drug ethambutol.

22, Ethambutol

Figure 7 Structure of the antituberculosis drug ethambutol.

[59]. This drug is active only against mycobacteria [8], and while it was thought for many years to be involved in inhibiting cell wall biosynthesis [60,61], its precise target was not elucidated until recently. The structure of the drug is relatively simple and bears little resemblance to any cell wall component, which have complicated the identification of its precise biochemical target. It is now known that the drug acts as an AraT inhibitor and disrupts the biosynthesis of the arabinan portions of both AG and LAM [43,47,62-64].

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