Drug Interactions between bcg vaccine and cycloserine

GENERALLY AVOID: Coadministration of antituberculosis drugs with the BCG vaccine may result in an inadequate immune response to the vaccine. The exact mechanism has not been described but it is likely that BCG vaccine, which contains a live, attenuated culture of Bacillus of Calmette and Guerin strain of Mycobacterium bovis, is sensitive to the antituberculosis effects of these drugs. Available data suggests that BCG vaccine is sensitive to commonly used antituberculosis agents such as isoniazid, ethambutol, and rifampin; it is reportedly not sensitive to pyrazinamide. However, clinical and/or sensitivity data are not available for BCG vaccine and all antituberculosis agents.

MANAGEMENT: Due to the potential loss of vaccine efficacy, the manufacturer recommends that concomitant use of antituberculosis drugs with the BCG vaccine should generally be avoided. However, in cases of accidental BCG overdosage, immediate treatment with antituberculosis drugs is recommended. In addition, if a systemic BCG infection is suspected after administration of the vaccine, antituberculosis therapy should be initiated and an infectious disease expert consulted for further guidance.