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REZ is a three-drug antituberculosis treatment regimen consisting of rifampin, ethambutol, and pyrazinamide. It is specifically utilized for patients who cannot tolerate or have resistance to isoniazid, a standard component of first-line tuberculosis therapy. The regimen was evaluated by the Centers for Disease Control and Prevention (CDC) Tuberculosis Trials Consortium (TBTC) in Study 24 as a 6-month intermittent (twice or thrice weekly) course. Rifampin inhibits bacterial RNA polymerase; ethambutol interferes with cell wall synthesis by inhibiting arabinosyl transferase; and pyrazinamide's mechanism involves disruption of membrane potential and transport, particularly in acidic environments.
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