COCCIDIN

Indications

• Impetigo
• Infected eczema
• Osteomyelitis
• Endocarditis
• Skin infections caused by Staphylococcus aureus

Dosage

Children: Refer to the BNF for Children for specific dosing guidelines based on the child's age and weight.

Adults: Refer to the BNF for specific dosing guidelines based on the condition being treated.

Mechanism of action

Fusidate inhibits bacterial protein synthesis by binding to the elongation factor G (EF-G) in bacteria. This binding prevents the translocation step of protein synthesis, effectively halting bacterial growth. The primary action occurs in the ribosomal machinery of the bacteria, leading to the inhibition of peptide chain elongation.

Pharmacodynamics

Fusidate exhibits bacteriostatic activity against a range of gram-positive organisms, particularly those resistant to other antibiotics. Its efficacy is enhanced when used in combination with other antibiotics, particularly in treating mixed infections. The drug demonstrates a high degree of selective toxicity, as it primarily affects bacterial ribosomes.

Pharmacokinetics

Fusidate is well-absorbed following oral administration, with peak plasma concentrations typically reached within a few hours. The drug is extensively distributed throughout body tissues, particularly in bone and skin. Fusidate is metabolized in the liver, and its elimination is primarily through bile. The half-life of fusidate can vary, necessitating careful consideration in dosing, particularly in patients with liver impairment.

Adverse effects

• Nausea
• Diarrhea
• Rash
• Pruritus
• Elevated liver enzymes

Precautions

• Monitor liver function tests during prolonged therapy
• Use with caution in patients with a history of liver disease

Pregnancy

Fusidate should only be used during pregnancy if clearly needed and after careful consideration of the risks and benefits.

Breast-feeding

Fusidate is excreted in breast milk. Caution should be exercised when administering to nursing mothers.

Storage

Store in a cool, dry place, away from direct sunlight. Keep out of reach of children.

Formulations

• Topical cream
• Topical ointment
• Oral tablet