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A special antibiotic is called ethambutol. It is used to treat tuberculosis.

What is Myambutol?

Ethambutol is a specialized antibiotic belonging to tuberculosis patients. It is considered a classic drug for the treatment of tuberculosis. It is also suitable for the treatment of other infections caused by mycobacteria. It is only used in combination with other preparations against mycobacteria.

Myambutol has been used in Europe since the 1960s. In Germany, the active ingredient is sold in a single preparation under the names Myambutol® and EMB-Fatol®.

Pharmacological effects

Ethambutol belongs to the group of tuberculostatic medicines. The drug can have growth inhibiting and bactericidal effects, depending on its concentration. Myambutol works against mycobacteria that are found outside the body's cells, but also against specimens hidden in phagocytes. However, a concentration of ethambutol seven times higher than normal should be administered for this purpose.

One of the advantages of Myambutol is the low resistance of mycobacteria to the antibiotic. Only about two percent of the bacterial genus Mycobacterium tuberculosis is insensitive to tuberculosis. For this reason, the drug is generally classified as the first choice. In addition, ethambutol can be effective in cases of intolerance to other anti-tuberculosis preparations.

Myambutol has the property of being rapidly absorbed by mycobacteria. It interferes with the normal structure of cell walls. The antibiotic, for example, disrupts the production of mycolic acid, an important cellular building block of lipids. This in turn has a negative effect on the cell wall structure of pathogens in the rapid growth phases. The same goes for resting mycobacteria, so the mechanism of action of the drug is independent of the particular phase of bacterial growth. However, it takes approximately 24 hours for significant growth inhibition to begin.

Other tuberculostatic drugs such as rifampicin or isoniazid are also supported by ethambutol. After taking it, the antibiotic quickly and almost completely enters the gastrointestinal tract. The active ingredient reaches its maximum concentration in the blood approximately two to four hours after ingestion. Almost unchanged, Myambutol is excreted by the body through the kidneys. A small part leaves the body through the bile.

Since ethambutol is enriched in the lungs by erythrocytes (red blood cells) as well as by macrophages and alveolar cells, its concentration in these cells is higher than in blood serum.

Medical application and use

The main area of aplication of Myambutol is the treatment of tuberculosis, triggered by the family of mycobacteria. The most common species is Mycobacterium tuberculosis. In contrast, Mycobacterium africani, Mycobacterium microti and Mycobacterium bovis are less common.

The antibiotic works against pathogens at all stages of the disease, even if other tissues outside the lungs are affected. However, a combination with other agents that act against tuberculosis is important. Often the drug is also given when tuberculosis comes back. In the event of proven resistance to bacteria, ethambutol serves as a reserve.

The antibiotic is administered as film-coated tablets. The patient takes the preparation once a day, regardless of meals. It is recommended to take the tablets on an empty stomach.

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Risks and side effects

The use of Myambutol can cause unwanted side effects in some people. This mainly includes inflammation of the optic nerve, which depends on the dose amount and the duration of treatment. The patient's color vision is initially disturbed. Thereafter, loss of visual field and in the worst case, visual disturbances to the point of blindness. For this reason, close monitoring by an ophthalmologist is necessary when administering ethambutol.

Other common side effects include increased uric acid levels, dizziness, headache, numbness of the limbs, trembling of the fingers, orientation problems, confusion and hallucinations. In addition, allergic reactions such as fever, rash or itching, kidney damage, changes in blood count or liver dysfunction may occur.

Bloating, bloating, abdominal pain, nausea and allergic shock are less common. In case of shock, Myambutol therapy should be stopped immediately. It is also important to alert an emergency doctor. In case of color vision disturbances, the patient should consult an ophthalmologist.

A contraindication to taking ethambutol is hypersensitivity to the drug, as well as the presence of eye disorders, through which precise control of vision is not possible. In case of inflammation of the optic nerve, gout or impaired kidney function, the doctor should carefully weigh the risk and benefits of Myambutol treatment.

The harmful effects of ethambutol during pregnancy are not known, although the antibiotic may enter the maternal cake (placenta). In addition, the agent passes into breast milk and its concentration is similar to that in the mother's blood. Basically, Myambutol can only be administered during pregnancy and lactation after a detailed check by the doctor.

Treatment with ethambutol in children can only take place from the age of 6 years. From this age, eye tests are possible with which a possible deterioration of vision can be checked.

Interactions are possible when taking Myambutol and other medicines at the same time. Aluminum hydroxide and similar acid inhibitors can reduce the effectiveness of the antibiotic. This risk also exists with the administration of magnesium and the additive [[spermine].

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