ethambutol
An ethylenediamine derivative that is ethane-1,2-diamine in which one hydrogen attached to each of the nitrogens is sutstituted by a 1-hydroxybutan-2-yl group (S,S-configuration). It is a bacteriostatic antimycobacterial drug, effective against Mycobacterium tuberculosis and some other mycobacteria. It is used (as the dihydrochloride salt) in combination with other antituberculous drugs in the treatment of pulmonary and extrapulmonary tuberculosis; resistant strains of M. tuberculosis are readily produced if ethambutol is used alone.
Classification
polyamine antibioticARO:3000527
-
CHEBI:23981 -
CHEBI:31577 - polyamine antibiotic
ARO:3000527
Chemical structure
| Molecular formula | C10H24N2O2 |
|---|---|
| Charge | 0 |
| Average mass | 204.314 Da |
| Monoisotopic mass | 204.18378 Da |
| Source | ChEBI |
| InChIKey | AEUTYOVWOVBAKS-UWVGGRQHSA-N |
CC[C@@H](CO)NCCN[C@@H](CC)CO
InChI=1S/C10H24N2O2/c1-3-9(7-13)11-5-6-12-10(4-2)8-14/h9-14H,3-8H2,1-2H3/t9-,10-/m0/s1
Also called
- etambutol
- ethambutolum
- (2S,2'S)-2,2'-(ethane-1,2-diyldiimino)dibutan-1-ol
- (+)-2,2'-(ethylenediimino)di-1-butanol
- (+)-N,N'-bis(1-(hydroxymethyl)propyl)ethylenediamine
- (+)-S,S-ethambutol
- (+)-ethambutol
- (2S,7S)-2,7-diethyl-3,6-diazaoctane-1,8-diol
- (S,S)-ethambutol
- EMB
- Ethambutol
- S,S-Ethambutol
Cross-references
- ethambutol
ARO:3000497 - cas:74-55-5
- kegg.compound:C06984
- reaxys:6312870
- chembl:CHEMBL44884
- pubchem.compound:14052
Drug registries
Patents and articles
Activity roles
- antitubercular agent
CHEBI:33231
Source concepts
| Source | Native ID | Label | Minted CURIE | Version |
|---|---|---|---|---|
| ARO | ARO:3000497 |
ethambutol | antibioticmech:aro-a472e0292c |
2026-08-30 |
| CHEBI | CHEBI:4877 |
ethambutol | antibioticmech:chebi-8ef15eb8e0 |
2026-08-30 |
Molecular targets
antibiotic sensitive aftA PROTEIN DIRECT_BINDING_TARGET
antibiotic sensitive embC PROTEIN DIRECT_BINDING_TARGET
antibiotic sensitive embA PROTEIN DIRECT_BINDING_TARGET
antibiotic sensitive embB PROTEIN DIRECT_BINDING_TARGET
Antibiotic sensitive embR PROTEIN SUSCEPTIBILITY_DETERMINANT
EmbA-EmbB and EmbC-EmbC arabinosyltransferase complexes PROTEIN_COMPLEX DIRECT_BINDING_TARGET
| Protein | Gene | Organism | Entry |
|---|---|---|---|
Arabinosyltransferase A UniProtKB:P9WNL9 |
embA | Mycobacterium tuberculosis (strain ATCC 25618 / H37Rv) NCBITaxon:83332 |
REVIEWED |
Arabinosyltransferase B UniProtKB:P9WNL7 |
embB | Mycobacterium tuberculosis (strain ATCC 25618 / H37Rv) NCBITaxon:83332 |
REVIEWED |
Arabinosyltransferase C UniProtKB:P9WNL5 |
embC | Mycobacterium tuberculosis (strain ATCC 25618 / H37Rv) NCBITaxon:83332 |
REVIEWED |
Mechanism summary
- Mode of action
- CELL_WALL_SYNTHESIS_INHIBITION microbial target
Activity spectrum
| Organism | Activity | MIC | Disk diffusion | Assay | Strain | Sample/genome | Evidence |
|---|---|---|---|---|---|---|---|
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 0.12 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
10 source isolates 10 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 0.12 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
5 source isolates 5 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 0.12 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
2 source isolates 2 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 0.25 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
80 source isolates 80 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 0.25 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
26 source isolates 26 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 0.25 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
3 source isolates 3 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 0.5 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
286 source isolates 286 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 0.5 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
91 source isolates 91 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 0.5 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
148 source isolates 148 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 1.0 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
1514 source isolates 1514 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 1.0 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
202 source isolates 202 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 1.0 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
325 source isolates 325 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 2.0 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
1462 source isolates 1462 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 2.0 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
123 source isolates 123 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 2.0 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
266 source isolates 266 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 4.0 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
590 source isolates 590 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 4.0 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
104 source isolates 104 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | SUSCEPTIBLE | 4.0 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
171 source isolates 171 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | RESISTANT | 8.0 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
737 source isolates 737 measurements |
EvidencePage data (JSON.gz) |
| Mycobacterium tuberculosis complex | RESISTANT | 8.0 mg/L | — | CRyPTIC DST; CRyPTIC; liquid media; microdilution plate; UKMYC5; critical concentration 4.0 mg/L | — |
23 source isolates 23 measurements |
EvidencePage data (JSON.gz) |
Resistance mechanisms
ANTIBIOTIC_TARGET_ALTERATION 19
| Determinant | ARO ID | Organism | Gene families | Evidence |
|---|---|---|---|---|
| Ethambutol resistant iniB | ARO:3004136 | — | ||
| Ethambutol resistant iniC | ARO:3003450 | — | ||
| Mycobacterium tuberculosis Rv1258c mutations confer resistance to ethambutol and capreomycin | ARO:3007185 | — | ||
| Mycobacterium tuberculosis aftA mutations confer resistance to ethambutol | ARO:3004951 | — | ||
| Mycobacterium tuberculosis embA mutant conferring resistance to ethambutol | ARO:3003453 | — | ||
| Mycobacterium tuberculosis embB with mutation conferring resistance to ethambutol | ARO:3003326 | — | ||
| Mycobacterium tuberculosis embC mutant conferring resistance to ethambutol | ARO:3003327 | — | ||
| Mycobacterium tuberculosis embR mutant conferring resistance to ethambutol | ARO:3003455 | — | ||
| Mycobacterium tuberculosis iniA mutant conferring resistance to ethambutol | ARO:3003448 | — | ||
| Mycobacterium tuberculosis iniB with mutation conferring resistance to ethambutol | ARO:3004135 | — | ||
| Mycobacterium tuberculosis iniC mutant conferring resistance to ethambutol | ARO:3003451 | — | ||
| Mycobacterium tuberculosis ubiA mutations confer resistance to ethambutol | ARO:3004950 | — | ||
| Mycobacterium tuberculosis variant bovis embB with mutation conferring resistance to ethambutol | ARO:3003325 | — | ||
| ethambutol resistant aftA | ARO:3002876 | — | ||
| ethambutol resistant embA | ARO:3003452 | — | ||
| ethambutol resistant embB | ARO:3000235 | — | ||
| ethambutol resistant embC | ARO:3002706 | — | ||
| ethambutol resistant embR | ARO:3003454 | — | ||
| ethambutol resistant iniA | ARO:3003447 | — |
Causal graphs
Ethambutol inhibits mycobacterial arabinan synthesis MECHANISTIC
Ethambutol inhibits Emb arabinosyltransferase complexes, reducing arabinan addition to arabinogalactan and lipoarabinomannan in the mycobacterial cell envelope.
| Node | Label | Type | Grounding |
|---|---|---|---|
ethambutol |
ethambutol | COMPOUND | CHEBI:4877 |
embab_complex |
mycobacterial EmbA-EmbB arabinosyltransferase complex |
GENE_OR_PROTEIN | REVIEWED_LABEL_ONLY |
embc_complex |
mycobacterial EmbC arabinosyltransferase complex |
GENE_OR_PROTEIN | REVIEWED_LABEL_ONLY |
arabinogalactan_arabinan |
mycobacterial arabinogalactan arabinan | CHEMICAL | REVIEWED_LABEL_ONLY |
lipoarabinomannan_arabinan |
mycobacterial lipoarabinomannan arabinan | CHEMICAL | REVIEWED_LABEL_ONLY |
cell_wall_arabinan_synthesis |
mycobacterial cell-wall arabinan synthesis | BIOLOGICAL_PROCESS | REVIEWED_LABEL_ONLY |
mycobacterial_cell_wall_integrity |
mycobacterial cell-wall integrity | CELL_STRUCTURE | REVIEWED_LABEL_ONLY |
| Subject | Predicate | Object | Evidence |
|---|---|---|---|
ethambutol |
binds | embab_complex |
|
ethambutol |
binds | embc_complex |
|
embab_complex |
participates in | arabinogalactan_arabinan |
|
embc_complex |
participates in | lipoarabinomannan_arabinan |
|
arabinogalactan_arabinan |
participates in | cell_wall_arabinan_synthesis |
|
lipoarabinomannan_arabinan |
participates in | cell_wall_arabinan_synthesis |
|
cell_wall_arabinan_synthesis |
supports | mycobacterial_cell_wall_integrity |
Record-level evidence
Curation history
-
SEEDED_FROM_SOURCES
Seeded from data/raw/ inventories (ARO, CHEBI)
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RESEEDED_FROM_SOURCES
Re-seeded from updated data/raw/ inventories
-
RESEEDED_FROM_SOURCES
Re-seeded from updated data/raw/ inventories
-
RESEEDED_FROM_SOURCES
Re-seeded from updated data/raw/ inventories
-
REVIEWED
Verified exact ChEBI/CARD stereochemical identity, structure, antimycobacterial role, class, FDA provenance, and retained CARD assertions; added cell-wall arabinan inhibition and the directly observed EmbB/EmbC complexes.
-
CURATED_CAUSAL_GRAPH
Added a PMID-supported causal graph for ethambutol inhibition of Emb-dependent mycobacterial cell-wall arabinan synthesis.
-
RESEEDED_FROM_SOURCES
Re-seeded from updated data/raw/ inventories
-
RESEEDED_FROM_SOURCES
Re-seeded; changed: activity_spectrum (CRYPTIC 3.4.0). Upstream retrieval date 2026-08-30, unchanged.
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RESEEDED_FROM_SOURCES
Re-seeded; changed: activity_membership_collections (CRYPTIC 3.4.0). Upstream retrieval date 2026-08-30, unchanged.
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CURATED_UNIPROT_PROTEIN_EXAMPLES
Added curated M. tuberculosis H37Rv EmbA (P9WNL9), EmbB (P9WNL7), and EmbC (P9WNL5) UniProtKB protein examples on the ethambutol_emb_arabinan_inhibition causal graph nodes and the PRIMARY_LITERATURE EmbA-EmbB / EmbC-EmbC arabinosyltransferase complexes molecular target.