Paper Title
Artesunate Increases Bactericidal Effect of Isoniazid-Rifampicin to Clinical MDR-TB Isolates

Tuberculosis is one of the infectious disease that rely on antibotics to eradicated. The emergence of first line anti tuberculosis drugs resistance aggravate this situation. Artesunate possesses the abilities to: (1) the production of free radicals to damage the bacterial membrane, (2) lower the antibiotic efflux pump proteins with lower expression mRNA Acra, AcrB, and TolC, (3) lower NO produced by bacteria, and (4) increase the hydroxyl radical in bacteria resulting in toxic effects on bacteria through modification of DNA bases and chain termination. Objective : to determine whether artesunate has an antimicrobial activity that increases bactericidal effect of Isoniazid-Rifampicin (INH-RIF) against Isoniazid-Rifampicin resistant Mycobacterium tuberculosis. Method : the method of laboratory experiment are the dilution method to determine the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC). The concentration of MBC of Artesunate was determined by way of 3 levels dilution thus obtained Artesunate 1 (ART 1) 120 mg / ml, Artesunate 2 (ART 2) 60 mg / ml, and 3 Artesunate (ART 3) 30 mg / ml. This experiment was repeated three times. Result : at the concentration INH-RIF-ART 1, INH-RIF-ART 2, and INH-RIF-ART 3 were found bactericidal effect to Isoniazid-Rifampicin resistant Mycobacterium tuberculosis. Conclusion: this study showed that there was increasing bactericidal effect of comibined Isoniazid-Rifampicin-Artesunate against Isoniazid-Rifampicin resistant Mycobacterium tuberculosis. Index Terms— Isoniazid, Rifampicin, Mycobacterium tuberculosis, Artesunate.