**Core Concept**
The treatment of tuberculosis (TB) involves the use of multiple drugs to target different stages of the bacterial life cycle. Persisters are a subpopulation of Mycobacterium tuberculosis that are resistant to bactericidal effects of antibiotics, requiring alternative therapeutic strategies.
**Why the Correct Answer is Right**
The most important drug for targeting persisters in TB is Bedaquiline (BDQ). BDQ works by inhibiting the proton pump (Mycobacterium smegmatis ATP synthase) in the mitochondria of M. tuberculosis, ultimately leading to the collapse of the proton gradient and ATP depletion. This action is particularly effective against persisters, which are less susceptible to traditional anti-TB agents.
**Why Each Wrong Option is Incorrect**
**Option A:** Isoniazid (INH) is a first-line anti-TB agent that targets the synthesis of mycolic acid, but it is not effective against persisters.
**Option B:** Rifampicin (RMP) is another first-line anti-TB agent that inhibits RNA synthesis, but it also has limited activity against persisters.
**Option C:** Ethambutol (EMB) is a first-line anti-TB agent that inhibits mycolic acid synthesis, but it is not effective against persisters.
**Clinical Pearl / High-Yield Fact**
It's essential to note that Bedaquiline should be used in combination with other anti-TB agents due to its potential for drug interactions and resistance development.
**Correct Answer:** C. Bedaquiline (BDQ)
Free Medical MCQs Β· NEET PG Β· USMLE Β· AIIMS
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