Prothionamide屬於thionamide類藥物，藉由抑制結核分枝桿菌之細胞壁合成，達到抗結核菌的效果，是為世界衛生組織(WHO)結核治療指引中的第二線藥物。本案例為一多重抗藥性肺結核失敗再治病患，53歲男性，結核病史長達八年。入院治療期間給予結核病第一線藥物rifinah 300、ethambutol(EMB)、streptomycin(SM)及第二線藥物cycloserine(CS)、moxifloxacin(MXFX)、prothionamide合併服用，而後在例行血液檢查中，病人出現疑似由prothionamide之藥物副作用造成的甲狀腺功能低下情形，目前已口服thyroxine sodium改善。期望藉由本案例報告，有效預防prothionamide引發甲狀腺功能低下之藥物不良反應，及未來可能的改善治療方法。

Prothionamide, a second-line anti-tuberculosis drug, inhibits cell wall biosynthesis of Mycobacterium tuberculosis. A 53-years-old male with multidrug-resistant tuberculosis for 8 years had multiple episodes of treatment failure. He was admitted to our hospital for management. Rifinah 300 mg, ethambutol (EMB), streptomycin (SM), cycloserine (CS), moxifloxacin (MXFX), and prothionamide were prescribed for his poorly controlled pulmonary tuberculosis. Although the patient reported no specific complain, prothionamide-induced hypothyroidism was  suspected after regular  blood  tests. Thyroxine sodium was added to his regimen, and subsequently, the thyroid-related profiles improved.
We reported this case to provide information related to the suspected adverse drug reaction of prothionamide  and  suggested  that  timely  interventions  may  be  given  to  patients  on  appropriate occasions.