A Mysterious, Interventional And Paradoxical Drug (PZA)

PZA is a mysterious, unconventional and paradoxical drug. The main reason is that PZA is very different from common antibiotics that are primarily active against growing bacteria and no or little activity for non-growing persisters. However, PZA is exactly the opposite to common antibiotics as it has no or little activity against growing tubercle bacilli and is primarily active against non-growing persisters.
PZA has no activity in vitro under normal culture conditions at neutral pH , but is active only at an acid pH (e.g. pH 5.5) in vitro . Furthermore, unlike other TB drugs, the activity of PZA increases with decreasing metabolic activity. PZA only kills M. tuberculosis slowly in vitro at acid pH . In vivo, PZA has high sterilizing activity