Which of the following drugs is most likely to be effective against multidrug-resistant strains of M. tuberculosis, including those resistant to streptomycin?

Amikacin is the second line antitubercular drug.Kanamycin, Amikacin and Capreomycin are more toxic antibiotics used as reserve drugs in rare cases not responding to the usual therapy, or infection by atypical mycobacteria. Any one of these is used at a time in combination with the commonly employed drugs to which resistance has not developed. Because all exhibit similar ototoxicity and nephrotoxicity, they are not combined among themselves or with streptomycin. Capreomycin, in addition, can induce electrolyte abnormalities. All act by inhibiting protein synthesis. None is effective orally; none penetrates meninges. All are excreted unchanged by the kidney. All are given in a dose of 0.75-1 .0 g i.m. per day. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION Page NO:744