Fucidin cream (Fusidic Acid)

Uses and administration

Fusidic acid is a topical antibiotic used to treat certain bacterial skin infections caused by susceptible organisms. It is most commonly used for localised infections such as impetigo or infected dermatitis. In the UK, use the medicine exactly as directed by your prescriber or pharmacist.

UK note: Fusidic acid products are available in the United Kingdom on prescription. The information below also reflects product information used outside the UK, and indications and availability may vary by country.

Topical fusidic acid 2% (20 mg/g) is used for primary and secondary bacterial skin infections caused by susceptible organisms, such as impetigo and other localised infected dermatoses. Adults and children: apply gently to the affected area three to four times daily on uncovered lesions; less frequent application may be enough under a dressing. Treatment usually lasts 7-14 days; follow your prescriber's directions.

Use on sensitive areas

Fucidin cream can be used on the face or other sensitive skin areas when prescribed for a bacterial skin infection. Apply a thin layer and take care around the eyes; avoid contact with mucous membranes. Fusidic acid is an antibiotic and is not meant as a general treatment for itchy skin unless the itching is linked to an underlying bacterial infection, such as infected eczema or dermatitis. If symptoms persist, spread, or the main problem is itching without clear signs of infection, a different treatment may be needed-seek medical advice.

Antimicrobial action

Fusidic acid is a steroidal antibiotic that works mainly against Gram-positive bacteria. It inhibits bacterial protein synthesis by blocking elongation factor G (EF-G), which is involved in translocation and elongation. It is very active against staphylococci, including Staphylococcus aureus (including methicillin-resistant strains in some settings), and may also have activity against some other Gram-positive organisms.

Resistance

Resistance of Staphylococcus aureus to fusidic acid has been reported, particularly with widespread topical use. To help reduce resistance, avoid prolonged or repeated use unless it is clinically indicated.

Side effects and precautions

With topical fusidic acid/sodium fusidate, side effects are usually limited to local skin reactions such as irritation, burning, itching or contact dermatitis. If severe irritation or signs of allergy occur, stop using it and seek medical advice.

As with all antibiotics, extended or repeated topical use may increase the risk of antibiotic resistance and contact sensitisation. Use the shortest effective course and avoid repeated courses unless advised by a clinician.

Take care when applying near the eyes, as local irritation may occur. If used while breast-feeding, avoid applying it to the breast to reduce the risk of the infant swallowing some of the product.

Do not smoke or go near naked flames while using this product because of a possible fire risk if fabric such as clothing, bedding or dressings becomes soaked with it; wash any fabrics that have been in contact with the product.

Interactions

No formal interaction studies have been carried out for topical fusidic acid. Interactions with medicines taken by mouth or given by other systemic routes are considered minimal because absorption through the skin is negligible.

Statins

Systemic fusidic acid should not be used together with statins because of a risk of severe rhabdomyolysis. This warning applies to systemic formulations; it is not expected with topical use because systemic absorption is negligible.

Storage

Store at room temperature and keep the tube tightly closed. Do not freeze. Keep out of the reach of children. Follow any additional storage instructions on the package label.