Which anti-TB medication may cause nephrotoxicity and should be used cautiously in diabetic patients?

Amikacin is an aminoglycoside antibiotic that is used in the treatment of multidrug-resistant tuberculosis. One of the significant concerns when prescribing amikacin is its potential for nephrotoxicity, which refers to damage to the kidneys that can occur as a side effect. This risk is particularly notable in patients who may have pre-existing kidney issues or conditions that predispose them to kidney damage, such as diabetes. In diabetic patients, there is often a higher baseline risk of kidney dysfunction, which makes careful monitoring and cautious use of nephrotoxic agents like amikacin essential.

Diabetic patients may experience complications that could exacerbate kidney issues, making the malign effects of nephrotoxic medications more pronounced. Therefore, while amikacin can be an effective choice in managing severe TB cases, it must be prescribed with caution, ensuring that renal function is assessed and monitored. This consideration for kidney health is vital in managing treatment effectively while minimizing the risk of adverse effects.

Other options, such as linezolid and ethambutol, do not carry the same level of nephrotoxicity risk, making them safer alternatives in managing TB for patients with concerns about kidney health. Sulfonylureas, on the other hand,