Viomycin is primarily used as an antibiotic in the treatment of tuberculosis, particularly in cases where the infection is resistant to first-line drugs like isoniazid and rifampin. It works by inhibiting protein synthesis in Mycobacterium tuberculosis, thereby preventing the bacteria from growing and multiplying. Due to its potential toxicity, including kidney damage and hearing loss, it is typically reserved for multidrug-resistant tuberculosis (MDR-TB) and administered under strict medical supervision. Viomycin is often used in combination with other antibiotics to enhance its effectiveness and reduce the risk of resistance development. Its use has declined with the advent of newer, less toxic drugs, but it remains an important option in challenging cases of drug-resistant tuberculosis.