Capreomycin sulfate is primarily used as a second-line treatment for multidrug-resistant tuberculosis (MDR-TB). It is administered via intramuscular or intravenous injection and works by inhibiting protein synthesis in Mycobacterium tuberculosis, effectively halting bacterial growth. This antibiotic is particularly valuable when first-line TB drugs, such as isoniazid and rifampin, are ineffective due to resistance. It is often combined with other antitubercular agents to enhance efficacy and reduce the risk of further resistance development. Due to its potential side effects, including kidney toxicity and hearing loss, its use requires careful monitoring of renal function and auditory health. Capreomycin sulfate plays a critical role in managing complex TB cases, especially in regions with high prevalence of drug-resistant strains.