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What is Pretomanid and explain in detail?
Pretomanid is an antibiotic medication used for the treatment of multi-drug-resistant tuberculosis affecting the lungs. It is generally used together with bedaquiline and linezolid. It is taken by mouth.The most common side effects include nerve damage, acne, vomiting, headache, low blood sugar, diarrhea, and liver inflammation. It is in the nitroimidazole class of medications.Pretomanid was approved for medical use in the United States in August 2019, and in the European Union in July 2020. Pretomanid was developed by TB Alliance. The U.S. Food and Drug Administration (FDA) considers it to be a first-in-class medication.

Medical uses
Pretomanid is indicated in combination with bedaquiline and linezolid, in adults, for the treatment of pulmonary extensively drug resistant (XDR), or treatment-intolerant or nonresponsive multidrug-resistant (MDR) tuberculosis (TB).

History
Pretomanid is the generic, nonproprietary name for the novel anti-bacterial drug compound formerly called PA-824.  Pretomanid is referred to as "Pa" in regimen abbreviations, such as BPaL. The "preto" part of the compounds name honors Pretoria, South Africa, the home of a TB Alliance clinical development office where much of the drugs development took place, while the "-manid" stem designates compounds with similar chemical structures.  This class of drug is variously referred to as nitroimidazoles or nitroimidazooxazines.  Development of this compound was initiated because of the urgent need for new antibacterial drugs effective against resistant strains of tuberculosis. Also, current anti-TB drugs are mainly effective against replicating and metabolically active bacteria, creating a need for drugs effective against persisting or latent bacterial infections as often occur in patients with tuberculosis.

Discovery and pre-clinical development
Pretomanid was first identified in 2000, in a series of 100 nitroimidazopyran derivatives synthesized and tested for antitubercular activity, by PathoGenesis (now a subsidiary of Novartis). Importantly, pretomanid has activity against static M. tuberculosis isolates that survive under anaerobic conditions, with bactericidal activity comparable to that of the existing drug metronidazole.  Pretomanid requires metabolic activation by Mycobacterium for antibacterial activity.  Pretomanid was not the most potent compound in the series against cultures of M