Formulary
Fusidic acid: Indications, Dosing, Side Effects and Interactions
Fusidic acid and its salts are narrow-spectrum antibiotics used for staphylococcal infections.
MedNext Academy | 4 min read
Fusidic acid: Indications, Dosing, Side Effects and Interactions
Fusidic acid and its salts are narrow-spectrum antibiotics used for staphylococcal infections.
Drug action
Fusidic acid and its salts are narrow-spectrum antibiotics used for staphylococcal infections.
Indications and dose
**Staphylococcal skin infection**
- **Child** (To The Skin): Apply 3-4 times a day usually for 7 days.
- **Adult** (To The Skin): Apply 3-4 times a day.
- **Child** (By Mouth Using Tablets): 12-17 years 250 mg every 12 hours for 5-10 days, dose expressed as sodium fusidate.
- **Adult** (By Mouth Using Tablets): 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],Secondary bacterial infection of eczema [**
- **Child** (To The Skin): for localised infections only] Apply 3 times a day for 5-7 days.
- **Adult** (To The Skin): Apply 3 times a day for 5-7 days.
**Staphylococcal eye infections**
- **Child** (To The Eye): Apply twice daily.
- **Adult** (To The Eye): Apply twice daily.
**Penicillin-resistant staphylococcal infection including osteomyelitis,Staphylococcal endocarditis in combination with other antibacterials**
- **Child** (By Mouth Using Oral Suspension): 12-17 years 750 mg 3 times a day.
- **Adult** (By Mouth Using Oral Suspension): 750 mg 3 times a day.
- **Child** (By Mouth Using Tablets): 12-17 years 500 mg every 8 hours, dose expressed as sodium fusidate, increased to 1 g every 8 hours, dose expressed as sodium fusidate, increased dose used for severe infections.
- **Adult** (By Mouth Using Tablets): 500 mg every 8 hours, dose expressed as sodium fusidate, increased to 1 g every 8 hours, dose expressed as sodium fusidate, increased dose used for severe infections.
**Staphylococcal infections due to susceptible organisms**
- **Child** (By Intravenous Infusion): (body-weight 50 kg and above) 500 mg 3 times a day, dose expressed as sodium fusidate.
- **Adult** (By Intravenous Infusion): (body-weight 50 kg and above) 500 mg 3 times a day, dose expressed as sodium fusidate.
**Staphylococcal skin infection for fusidic acid**
- **Child** (To the skin): Apply 3-4 times a day usually for 7 days.
- **Child 12-17 years** (By mouth using tablets): 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], Secondary bacterial infection of eczema [for localised infections only] for fusidic acid**
- **Child** (To the skin): Apply 3 times a day for 5-7 days.
**Staphylococcal eye infections for fusidic acid**
- **Child** (To the eye): Apply twice daily.
**Penicillin-resistant staphylococcal infection including osteomyelitis, Staphylococcal endocarditis in combination with other antibacterials for fusidic acid**
- **Neonate** (By mouth using oral suspension): 15 mg/kg 3 times a day.
- **Child 1-11 months** (By mouth using oral suspension): 15 mg/kg 3 times a day.
- **Child 1-4 years** (By mouth using oral suspension): 250 mg 3 times a day.
- **Child 5-11 years** (By mouth using oral suspension): 500 mg 3 times a day.
- **Child 12-17 years** (By mouth using oral suspension): 750 mg 3 times a day.
- **Child 12-17 years** (By mouth using tablets): 500 mg every 8 hours, dose expressed as sodium fusidate, increased to 1 g every 8 hours, dose expressed as sodium fusidate, increased dose used for severe infections.
**Staphylococcal infections due to susceptible organisms for fusidic acid**
- **Child (body-weight up to 50 kg)** (By intravenous infusion): 6-7 mg/kg 3 times a day, dose expressed as sodium fusidate.
- **Child (body-weight 50 kg and above)** (By intravenous infusion): 500 mg 3 times a day, dose expressed as sodium fusidate.
Cautions
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.
Side effects
General side-effects: Uncommon Skin reactions Specific side-effects: Common or very common When used by eye (topical) Dry eye; eye discomfort; vision blurred 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 When used by eye (topical) Crying on application; watering eye With intravenous use Appetite decreased; asthenia; headache; malaise With oral use Appetite decreased; asthenia; headache; malaise; rash pustular; rhabdomyolysis Rare or very rare With topical use Angioedema; conjunctivitis Frequency not known When used by eye (topical) Angioedema; eye inflammation 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; 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.
Pregnancy
With systemic use: Not known to be harmful; manufacturer advises use only if potential benefit outweighs risk.
Breast feeding
With systemic use: Present in milk-manufacturer advises caution.
Hepatic impairment
With systemic use: Manufacturer advises caution.
Medicinal forms
Suspension,Tablet,Suspension,Drops,Solution,Cream,Ointment
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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