Used as a second-line antibiotic in the treatment of multidrug-resistant tuberculosis (MDR-TB), particularly when first-line drugs are ineffective or not tolerated. It is administered by injection and works by inhibiting bacterial protein synthesis, targeting the ribosome of Mycobacterium tuberculosis. Due to its potential for toxicity, especially nephrotoxicity and ototoxicity, it is typically reserved for cases where other treatment options have failed. Its use is generally limited to short durations under close medical supervision as part of a combination therapy regimen.