Pasiniazid is primarily used in the treatment of tuberculosis, particularly in cases where patients may have developed resistance to other first-line anti-tuberculosis drugs. It is often administered in combination with other anti-tubercular agents to enhance its efficacy and reduce the risk of further resistance development. The compound works by inhibiting the synthesis of mycolic acids, which are essential components of the bacterial cell wall, thereby preventing the growth and replication of Mycobacterium tuberculosis. Its use is carefully monitored due to potential side effects, including hepatotoxicity, and it is typically prescribed under strict medical supervision to ensure optimal therapeutic outcomes.