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This is a combination regimen of three antibiotics—ciprofloxacin, rifampicin (also known as rifampin), and ethambutol—used primarily in the treatment of mycobacterial infections, including tuberculosis (TB) and non-tuberculous mycobacterial (NTM) diseases such as Mycobacterium avium complex (MAC). - **Ciprofloxacin** is a fluoroquinolone antibiotic that inhibits bacterial DNA gyrase and topoisomerase IV, enzymes essential for bacterial DNA replication. - **Rifampicin** is a rifamycin antibiotic that inhibits bacterial DNA-dependent RNA polymerase, thereby suppressing RNA synthesis. - **Ethambutol** is a bacteriostatic agent that inhibits arabinosyl transferases involved in cell wall biosynthesis in mycobacteria. This combination may be used when first-line agents are not suitable or when treating resistant or atypical mycobacterial infections. The regimen targets multiple pathways to reduce the risk of resistance development[1][2][4][7].
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