Used primarily in the treatment of multidrug-resistant tuberculosis (MDR-TB), this compound targets the bacterial ATP synthase enzyme, disrupting energy production in Mycobacterium tuberculosis. It demonstrates potent bactericidal activity, especially against dormant or slow-growing bacilli, which are often less responsive to conventional TB drugs. Due to its unique mechanism of action, it is considered a key component in salvage therapy regimens for patients who fail first-line treatments. It has shown improved treatment outcomes when included in combination therapy, reducing sputum positivity and improving culture conversion rates. Its use is generally reserved for confirmed or highly suspected drug-resistant cases due to concerns about resistance development and limited long-term safety data.