Fusidic acid

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.

4–6 h

Bacteroides fragilis, clostridia, gonococcus, meningococcus, staphylococci.

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

Pregnancy, nursing.

• 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.

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

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

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

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).

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