What should we pay attention to when treating drug-resistant tuberculosis with cycloserine?

Cycloserine（Cycloserine) is a second-line anti-tuberculosis drug, mainly used in patients with multi-drug-resistant or refractory tuberculosis. The treatment cycle of drug-resistant tuberculosis is long and the drugs are complex. The use of cycloserine needs to take into account both efficacy and safety. First of all, it is necessary to confirm that tuberculosis bacteria are sensitive to cycloserine through drug susceptibility testing; secondly, when using ethambutol, pyrazinamide and other drugs in combination, one needs to be alert to the superposition of neurotoxicity caused by drug interactions. Monthly neurological assessments, including mood scales and cognitive function tests, are recommended during treatment. High-fat meals should be avoided in diet, as fat may affect drug absorption. If serious adverse reactions occur, doctors will consider replacing it with new anti-tuberculosis drugs such as bedaquiline.