Which pair of antituberculosis drugs has the potential to worsen a patient's gout symptoms?

The correct answer highlights the combination of ethambutol and pyrazinamide as having the potential to worsen a patient's gout symptoms. Pyrazinamide, in particular, is known to increase uric acid levels in the blood, which can exacerbate gout. When the uric acid levels rise, it can lead to the formation of urate crystals that accumulate in the joints and tissues, resulting in painful gout flares.

Ethambutol does not directly affect uric acid levels significantly, but it is often used in combination therapy for tuberculosis alongside pyrazinamide, which can further compound the effects of increased uric acid from pyrazinamide. As a result, while ethambutol alone may not worsen gout, when combined with pyrazinamide, the overall risk of gout symptoms may be heightened due to the latter's impact on uric acid metabolism.

This understanding of pyrazinamide’s effects relates specifically to its mechanism of action and pharmacodynamic profile, making this pair particularly pertinent for patients with a history of gout or hyperuricemia. Decisions for treatment must carefully consider these side effects, especially in patients vulnerable to gout flares.