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 often used for localised infections such as impetigo or infected dermatitis. Use the medicine exactly as directed by your Australian prescriber.

Australian note: Fusidic acid products are available in Australia, but indications, scheduling and product availability can vary. Check the information below against current Australian product information.

Topical fusidic acid 2% (20 mg/g) is used for primary and secondary bacterial skin infections caused by susceptible organisms, for example 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 courses are commonly 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 in Australia 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 related to an underlying bacterial infection, for example infected eczema or dermatitis. If symptoms continue, 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 antibacterial that is active 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 an Australian clinician.

Use with care when applying near the eyes, as local irritation may occur. If used during breast-feeding, avoid applying it on the breast to reduce the risk of unintentional oral exposure to the infant.

Patients should not smoke or go near naked flames while using this product because there is a potential fire risk if fabric (clothing, bedding or dressings) becomes impregnated with it; wash any fabrics that have been in contact with the product.

Interactions

No formal interaction studies have been performed for topical fusidic acid. Interactions with medicines taken by mouth or given systemically are considered minimal because systemic absorption after topical use 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 reach of children. Follow any additional storage instructions on the package label.