Fusidic acid

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

acidum fusidicum; CAS number: 6990-6-3; fusidic acid

Definition
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Bacteriostatically active, lipophilic antibiotic with steroid structure (group of steroid antibiotics) which inhibits protein synthesis in bacteria (see structural formula). Fusidic acid is a fermentation product of Fusidium coccineum and belongs to the Fusidane family.

Half-life
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4–6 h

Spectrum of action
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Bacteroides fragilis, clostridia, gonococcus, meningococcus, staphylococci.

Indication
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Skin and soft tissue infections caused by bacteria sensitive to fusidic acid Sepsis, osteomyelitis, pneumonia. Fusidic acid can be combined with betalactam antibiotics.

Limited indication
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Pregnancy, nursing.

Dosage and method of use
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  • Topical:
  • Eye drops: On the 1st day, every 4 hours apply 1 trp. then twice a day 1 trp. into the conjunctival sac.
  • Gauze: Leave for 2-3 days, change the overlying dressing daily.
  • Ointment/cream: Apply 1-3 times/day and cover with bandage.

  • Remember! High risk of sensitization with topical application!

  • Systemic (fusidic acid no longer plays an important role as a systemic therapeutic agent): Adults 3 times/day 1.5 g p.o. or 1.5-2 g i.v./day in 3-4 ED. Children 0.75-1.5 g p.o. or 20 mg/kg bw i.v./day in 3 sessions.

Standard concentration
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2% as ointment and gel, 0.5% as solution, 1% as eye drops.

Undesirable effects
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Stomach pains, nausea, jaundice, liver dysfunction, rarely granulopenia, thrombopenia. Rarely a slight burning sensation at the beginning of topical application. Rarely contact dermatitis.

Preparations
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Fucidine ointment/gauze/cream, Fucithalmic eye drops; Fucidin tbl/ampoules are currently only available from the international pharmacy

Note(s)
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In recent years, fusidic acid resistance has increasingly developed in Staphylococcus aureus. They are now at about 40% and thus have considerable therapeutic relevance (Edslev et al. 2018).

Literature
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  1. Edslev SM et al(2018) Genomic analysis reveals different mechanisms of fusidic acid resistance in Staphylococcus
    aureus from Danish atopic dermatitis patients. J Antimicrob Chemother73:856-861.
  2. Mitra A et al (2008) High levels of fusidic acid-resistant Staphylococcus aureus despite restrictions on antibiotic use. Clin Exp Dermatol 34: 136-139

Incoming links (3)

Antibiotics; Tumbu myiasis; Tungiasis;

Outgoing links (1)

Antibiotics;

Authors

Last updated on: 29.10.2020