Drug Action
Fusidic acid and its salts are narrow- spectrum antibiotics used for staphylococcal infections.
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Drug reference
Fusidic acid and its salts are narrow- spectrum antibiotics used for staphylococcal infections.
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Staphylococcal skin infection ▶TO THE SKIN ▶Child: Apply 3–4 times a day usually for 7 days ▶Adult: Apply 3–4 times a day ▶BY MOUTH USING TABLETS ▶Child 12–17 years: 250 mg every 12 hours for 5-10 days, dose expressed as sodium fusidate ▶Adult: 250 mg every 12 hours for 5-10 days, dose expressed as sodium fusidate Non-bullous impetigo [in patients who are not systemically unwell or at high risk of complications] ▶TO THE SKIN ▶Child: Apply 3 times a day for 5–7 days ▶Adult: Apply 3 times a day for 5–7 days Penicillin-resistant staphylococcal infection including osteomyelitis | Staphylococcal endocarditis in combination with other antibacterials ▶BY MOUTH USING ORAL SUSPENSION ▶Child 1–11 months: 15 mg/kg 3 times a day ▶Child 1–4 years: 250 mg 3 times a day ▶Child 5–11 years: 500 mg 3 times a day ▶Child 12–17 years: 750 mg 3 times a day ▶Adult: 750 mg 3 times a day ▶BY MOUTH USING TABLETS ▶Child 12–17 years: 500 mg every 8 hours, increased to 1 g every 8 hours, increased dose can be used for severe infections, dose expressed as sodium fusidate ▶Adult: 500 mg every 8 hours, increased to 1 g every 8 hours, increased dose can be used for severe infections, dose expressed as sodium fusidate Staphylococcal infections due to susceptible organisms ▶BY INTRAVENOUS INFUSION ▶Child (body-weight up to 50 kg): 6–7 mg/kg 3 times a day, dose expressed as sodium fusidate ▶Child (body-weight 50 kg and above): 500 mg 3 times a day, dose expressed as sodium fusidate ▶Adult (body-weight up to 50 kg): 6–7 mg/kg 3 times a day, dose expressed as sodium fusidate ▶Adult (body-weight 50 kg and above): 500 mg 3 times a day, dose expressed as sodium fusidate DOSE EQUIVALENCE AND CONVERSION ▶With oral use ▶Fusidic acid is incompletely absorbed and doses recommended for suspension are proportionately higher than those for sodium fusidate tablets.
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▶With systemic use Impaired transport and metabolism of bilirubin ▶With topical use Avoid contact of cream or ointment with eyes CAUTIONS, FURTHER INFORMATION ▶Avoiding resistance ▶With topical use To avoid the development of resistance, fusidic acid should not be used for longer than 10 days and local microbiology advice should be sought before using it in hospital.
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For choice of antibacterial therapy, see Cardiovascular system infections, antibacterial therapy p. 532, Musculoskeletal system infections, antibacterial therapy p. 536, Skin infections, antibacterial therapy p. 540. l PROFESSION SPECIFIC INFORMATION Dental practitioners’ formulary ▶With topical use May be prescribed as Sodium Fusidate ointment.
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→Appendix 1: fusidate
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GENERAL SIDE-EFFECTS ▶Uncommon Skin reactions SPECIFIC SIDE-EFFECTS ▶Common or very common ▶With intravenous use Dizziness. drowsiness. hepatic disorders. hyperbilirubinaemia. thrombophlebitis. vascular pain (reduced if given via central vein) ▶With oral use Diarrhoea. dizziness. drowsiness. gastrointestinal discomfort. nausea. vomiting ▶Uncommon ▶With intravenous use Appetite decreased. asthenia. headache. malaise ▶With oral use Appetite decreased. asthenia. headache. malaise. rash pustular ▶Rare or very rare ▶With topical use Angioedema. conjunctivitis ▶Frequency not known ▶With intravenous use Agranulocytosis. anaemia. leucopenia . neutropenia. pancytopenia. renal failure. rhabdomyolysis. thrombocytopenia ▶With oral use Agranulocytosis. anaemia. hepatic disorders. hyperbilirubinaemia. leucopenia. neutropenia. pancytopenia. renal failure. rhabdomyolysis. thrombocytopenia SIDE-EFFECTS, FURTHER INFORMATION Elevated liver enzymes, hyperbilirubinaemia and jaundice can occur with systemic use—these effects are usually reversible following withdrawal of therapy.
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▶With systemic use Not known to be harmful; manufacturer advises use only if potential benefit outweighs risk.
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▶With systemic use Present in milk—manufacturer advises caution.
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▶With systemic use Manufacturer advises caution.
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▶With systemic use Manufacturer advises monitor liver function with high doses or on prolonged therapy; monitoring also advised for patients with biliary tract obstruction, those taking potentially hepatotoxic medication, or those taking concurrent medication with a similar excretion pathway.
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▶With intravenous use Manufacturer advises for intravenous infusion, give intermittently in Sodium chloride 0.9% or Glucose 5%; reconstitute each vial with 10 mL buffer solution, then add contents of vial to 500 mL infusion fluid to give a solution containing approximately 1 mg/mL. Give requisite dose via a central line over 2 hours (give over at least 6 hours if administered via a large peripheral vein).
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There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 9 ▶Fucidin (LEO Pharma) Sodium fusidate 250 mg Fucidin 250mg tablets | 10 tablet P £6.02 DT = £6.02 | 100 tablet P £54.99 Oral suspension CAUTIONARY AND ADVISORY LABELS 9 ▶Fucidin (LEO Pharma) Fusidic acid 50 mg per 1 ml Fucidin 250mg/5ml oral suspension | 90 ml P £12.11 Cream EXCIPIENTS: May contain Butylated hydroxyanisole, cetostearyl alcohol (including cetyl and stearyl alcohol) ▶Fusidic acid (Non-proprietary) Fusidic acid 20 mg per 1 gram Fusidic acid 2% cream | 15 gram P £3.00 DT = £2.64 | 30 gram P £5.28 DT = £5.28 ▶Fucidin (LEO Pharma) Fusidic acid 20 mg per 1 gram Fucidin 20mg/g cream | 15 gram P £1.92 DT = £2.64 | 30 gram P £3.59 DT = £5.28 Ointment EXCIPIENTS: May contain Cetostearyl alcohol (including cetyl and stearyl alcohol), woolfat and related substances (including lanolin) ▶Fucidin (LEO Pharma) Sodium fusidate 20 mg per 1 gram Fucidin 20mg/g ointment | 15 gram P £2.68 DT = £2.68 | 30 gram P £4.55 DT = £4.55 Powder and solvent for solution for infusion ELECTROLYTES: May contain Sodium ▶Fusidic acid (Non-proprietary) Sodium fusidate 500 mg Sodium fusidate 500mg powder and solvent for solution for infusion vials | 1 vial P £20.50–£20.90 DT = £20.70
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Apply 3–4 times a day usually for 7 days
First-line fragment. Read the complete Indications and Dose section above.
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250 mg every 12 hours for 5-10 days,
First-line fragment. Read the complete Indications and Dose section above.
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Apply 3 times a day for 5–7 days
First-line fragment. Read the complete Indications and Dose section above.
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15 mg/kg 3 times a day
First-line fragment. Read the complete Indications and Dose section above.
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250 mg 3 times a day
First-line fragment. Read the complete Indications and Dose section above.
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500 mg 3 times a day
First-line fragment. Read the complete Indications and Dose section above.
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750 mg 3 times a day
First-line fragment. Read the complete Indications and Dose section above.
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500 mg every 8 hours, increased to 1 g
First-line fragment. Read the complete Indications and Dose section above.
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6–7 mg/kg 3 times a day,
First-line fragment. Read the complete Indications and Dose section above.
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500 mg 3 times a
First-line fragment. Read the complete Indications and Dose section above.
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