Which anti-TB drug does not require pyridoxine prophylaxis?

Delamanid is an anti-TB drug that does not require pyridoxine prophylaxis. Pyridoxine, or vitamin B6, is often administered as a preventative measure alongside certain tuberculosis medications, particularly isoniazid, to combat peripheral neuropathy, a common side effect associated with that drug.

Delamanid, however, works through a different mechanism and does not pose the same risk for causing neuropathy as isoniazid does. This allows it to be used without the additional requirement for pyridoxine supplementation, making it a unique choice among anti-TB therapies in this regard.

In contrast, isoniazid is widely known for its association with neurological side effects, thus necessitating the routine use of pyridoxine to mitigate such effects. Linezolid and cycloserine may also have specific side effects that require careful monitoring or additional treatments, but they do not have the same established need for pyridoxine prophylaxis that isoniazid has.