ABSTRACT
Thiacetazone (also called thioacetazone, tibione or amithiozone) is a thiosemicarbazone that was synthesized by Behnisch and Schmidt and investigated clinically by Gerhard Domagk and co-workers in Germany in the 1940s (Daniel, 2005; Domagk, 1950; Dooley et al., 2013). It was subsequently shown to be active alone or when combined with streptomycin in patients with tuberculosis in the USA (Davis et al., 1950). It is active against Mycobacterium tuberculosis, but was initially considered too toxic for widespread use (Hinshaw and McDermott, 1950). However, thiacetazone is extremely cheap to manufacture and stable in harsh climatic conditions and it became a common component of tuberculosis treatment protocols particularly in Africa, often combined with isoniazid in a single oral formulation (De Cock, 1995; De Cock and Wilkinson, 1995; Falzon et al., 2014). Its primary purpose was to prevent the development of resistance to isoniazid (Dooley et al., 2013; Martinez and Hernandez, 1996; Rieder and Enarson, 1996). In patients co-infected with human immunodeficiency virus (HIV), thiacetazone causes unacceptably high rates of severe cutaneous reactions, leading to controversy about its continued value in the treatment of tuberculosis (Elliott and Foster, 1996; Falzon et al., 2014; Fegan, 1995; McLeod et al., 1989; Nunn et al., 1993; Rieder and Enarson, 1996).
