Pretomanid: The latest USFDA-approved anti-tuberculosis drug

Pretomanid is a nitroimidazooxazine drug which inhibits synthesis of mycolic acid. This leads to defective cell wall formation, ultimately causing bacterial cell death. It is active against both replicating and non-replicating M. tuberculosis . Following promising result in a phase III trial, pretomanid was approved by United States Food and Drug Administration in August 2019. This orally active drug has been approved as part of a combination regimen of bedaquiline, pretomanid and linezolid (BPaL regimen) to treat adults with pulmonary extensive drug resistant tuberculosis (TB) or treatment-intolerant or non-responsive multidrug resistant TB. Peripheral neuropathy and increased liver enzymes are some of the reported adverse events associated with pretomanid. However, more studies are required to confirm the role of pretomanid in paediatric, geriatric and HIV co-infection cases. • Pretomanid is a nitroimidazooxazine drug which inhibits synthesis of mycolic acid. • It is active against both replicating and non-replicating Mycobacterium tuberculosis. • Approval of pretomanid by United States Food and Drug Administration (USFDA) in August 2019. • Pretomanid has been approved for treatment of adults with pulmonary XDR-TB or treatment-intolerant or non-responsive MDR-TB. • Pretomanid is currently recommended to be administered in combination with bedaquiline and linezolid.