Alpibectir demonstrates the ability to restore therapeutic efficacy to ethionamide, a tuberculosis drug largely abandoned due to bacterial resistance mechanisms. The compound appears to overcome specific resistance pathways that rendered ethionamide ineffective against modern TB strains, potentially returning a once-promising antimycobacterial agent to clinical utility. This represents a novel approach to addressing drug-resistant tuberculosis through chemical rescue of discontinued therapeutics rather than developing entirely new compounds. The strategy could prove particularly valuable given the urgent need for effective treatments against multidrug-resistant and extensively drug-resistant TB strains, which have severely limited therapeutic options. However, the mechanism by which alpibectir restores ethionamide sensitivity remains to be fully elucidated, and clinical trials will be essential to determine whether this combination can safely achieve therapeutic concentrations in humans. The approach of reviving abandoned antibiotics through adjunct compounds represents an increasingly important strategy in antimicrobial development, offering potentially faster pathways to new treatments compared to de novo drug discovery. Success here could establish a template for rescuing other shelved antimicrobials.