Fusiderm Cream

Indications

• Bacterial skin infections
• Impetigo
• Infected dermatitis
• Osteomyelitis
• Endocarditis

Dosage

Children: Refer to BNF for Children for appropriate dosing recommendations.

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

Mechanism of action

Fusidic acid exerts its antibacterial effect by inhibiting bacterial protein synthesis. It binds to the elongation factor G (EF-G) in bacteria, preventing the translocation step during protein synthesis. This action effectively halts the production of proteins necessary for bacterial growth, leading to cell death.

Pharmacodynamics

Fusidic acid demonstrates time-dependent killing against susceptible bacteria. Its antibacterial spectrum includes gram-positive organisms, especially staphylococci. The drug's efficacy is influenced by the concentration at the site of infection and the duration of exposure, with higher concentrations generally leading to greater antibacterial activity.

Pharmacokinetics

Fusidic acid is well absorbed when administered orally, with peak plasma concentrations occurring within one to two hours. It is extensively protein-bound, primarily to albumin. The drug is metabolized in the liver and has a relatively long half-life of approximately 6 to 8 hours, allowing for less frequent dosing. The majority of the drug is excreted in the bile, with a minor amount appearing in the urine.

Contra-indications

• Hypersensitivity to fusidic acid or any of its components
• Severe liver impairment

Adverse effects

• Nausea
• Vomiting
• Diarrhea
• Rash
• Hepatotoxicity
• Jaundice
• Thrombocytopenia

Interactions

• May interact with anticoagulants such as warfarin, enhancing their effects
• Co-administration with statins may increase the risk of myopathy
• Potential interaction with cyclosporine, leading to increased plasma levels of cyclosporine

Precautions

• Use with caution in patients with liver disease
• Monitor liver function tests in prolonged therapy
• Evaluate for signs of allergic reactions
• Consider the potential for drug interactions, particularly with hepatic enzyme inducers or inhibitors

Pregnancy

Fusidic acid is classified as category C. It should only be used if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

Fusidic acid is excreted in breast milk. Caution is advised when administering to breastfeeding mothers.

Storage

Store at room temperature, away from light and moisture. Keep out of reach of children.

Formulations

• Topical cream
• Topical ointment
• Oral tablets
• Intravenous injection