moxifloxacin + rifampin + pyrazinamide + ethambutol

This is a four-drug combination regimen used primarily for the treatment of drug-susceptible pulmonary tuberculosis. The regimen consists of moxifloxacin, a fluoroquinolone antibiotic that inhibits DNA gyrase; rifampin (also known as rifampicin), an antibiotic that inhibits bacterial RNA polymerase; pyrazinamide, which disrupts *Mycobacterium tuberculosis* membrane transport and energy production; and ethambutol, which inhibits arabinosyl transferases involved in cell wall biosynthesis. This combination is sometimes used as an alternative to the standard first-line TB therapy (which typically includes isoniazid instead of moxifloxacin) or in cases where resistance or intolerance to other agents exists. Moxifloxacin may be substituted for ethambutol in some regimens to potentially enhance sterilizing activity, though evidence suggests it does not significantly shorten treatment duration when added to standard therapy[5]. The primary indication is active tuberculosis caused by *Mycobacterium tuberculosis*.

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