ABSTRACT
Capreomycin is an important reserve antibiotic for the treatment of tuberculosis and has been used for this purpose for more than 40 years (Cohen and Yue, 1966; Cuthbert and Bruce, 1964; Kass, 1965). It is a naturally produced cyclic polypeptide composed of nonproteinogenic amino acids and biosynthesized by a nonribosomal protein synthase by Streptomyces capreolus (Barkei et al., 2009; Chopra et al., 2012; Felnagle et al., 2008; Thomas et al., 2003). Capreomycin was first isolated in 1959 from S. capreolus at the Lilly Laboratories in Indiana (Herr et al., 1959). It consists of four microbiologically active compounds—capreomycin IA, IB, IIA, and IIB in the approximate proportions of 25%, 67%, 3%, and 6%, respectively (Chopra et al., 2012; Herr and Redstone, 1966; Nomoto et al., 1977; Shiba et al., 1976). For clinical purposes, capreomycin is given as a sulfate (predominantly capreomycin IA and IB). The chemical structures of capreomycin IA and IB are shown in Figure 134.1. Chemical structure of two capreomycin compounds. https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781315152110/08d8042d-9481-4a8d-8c27-9bd589f6de6b/content/fig134_1.tif" xmlns:xlink="https://www.w3.org/1999/xlink"/>
