Cycloserine

KEY POINTS

• Cycloserine (Seromycin) is an antimicrobial agent that works by inhibiting bacterial cell wall synthesis through competing with amino acid D-alanine for incorporation into the cell wall
  • May be used versus Mycobacterium tuberculosis or for urinary tract infections
• Manufacturer label recommends dose of 250mg twice daily for 14 days then 500mg to 1000mg per day given twice daily, max dose of 1,000mg per day
  • Adjust dose for renal impairment
• Only used under circumstances where conventional therapies have failed or are not options
  • Toxicities limit its utility
    • Beware CNS effects and skin reactions, among many others
    • Beware vitamin B12 and/or folate deficiency
• Can be very expensive

RESOURCES

• Cycloserine Package Insert
• Infectious Diseases Society of America Guidelines
• World Health Organization Guidelines On Tuberculosis
• Opportunistic Infection Guideline (AIDSinfo)
• Role Of Old Antimicrobial Agents In The Management Of Urinary Tract Infection (2016)