Fusidic Acid

Indications
 Oral
Susceptible infections
Adult: 500 mg tid. May increase to 1 g tid in fulminating infections.
Child: <1 yr: About 15 mg/kg; 1-5 yr: 250 mg; 5-12 yr: 500 mg. Doses to be taken tid.
Intravenous
Susceptible infections
Adult: >50 kg: 500 mg tid; may increase to 1 g tid in fulminating infections. <50 kg: 6-7 mg/kg tid. To be given by slow IV infusion over at least 2 hr; should be given via a large vein with good blood flow.
Child: 20 mg/kg daily in 3 divided doses. To be given by slow IV infusion over at least 2 hr; should be given via a large vein with good blood flow.
Ophthalmic
Conjunctivitis
Adult: As 1% eye drops: Instill 1 drop into the affected eye every 12 hr for 7 days.
Child: ≥2 yr: As 1% eye drops: Instill 1 drop into the affected eye every 12 hr for 7 days.
Topical/Cutaneous
Skin infections
Adult: As a 2% ointment/cream/gel: Apply onto affected area 3-4 times daily until there is improvement. If gauze dressing is used, then frequency of application may be reduced to 1-2 times daily.
Child: As a 2% ointment/cream/gel: Apply onto affected area 3-4 times daily until there is improvement. If gauze dressing is used, then frequency of application may be reduced to 1-2 times daily.

Reconstitution: Each 500 mg dose is given as a buffered solution (pH 7.4-7.6) diluted to 500 ml with sodium chloride or other suitable IV solution.
Incompatibility: Incompatible with amino acid solutions or whole blood. Admixture incompatibility: Carbenicillin, kanamycin, gentamicin, calcium solutions.
Contraindications
 Hypersensitivity.
Warnings / Precautions
 Hepatic disease; monitor liver function. Neonates; pregnancy, lactation.
Adverse Reactions
 Jaundice and liver dysfunction (reversible); GI disturbances. IV: Venospasm, thrombophloebitis and haemolysis; hypocalcaemia. SC/IM: Tissue necrosis. Topical: Rashes and irritation.
Drug Interactions
 Synergistic action with antistaphylococcal penicillin. Antagonism with ciprofloxacin.
See Below for More fusidic acid Drug Interactions
Food Interactions
 Delays absorption for oral preparations.
Mechanism of Actions
 Fusidic acid disrupts translocation of peptide subunits and elongating the peptide chain of susceptible bacteria, thus inhibiting protein synthesis.
Absorption: Well-absorbed from the GI tract (oral); mean plasma concentrations of 30 mcg/ml after 2-4 hr (500-mg dose). More rapid absorption in children than in adults.
Distribution: Widely distributed into tissues and body fluids including bone, pus and synovial fluid; crosses the placenta and enters breast milk. Protein-binding: 95%.
Metabolism: Hepatic; converted to multiple metabolites.
Excretion: Bile (mainly as metabolites), faeces (2% as unchanged drug), urine; 5-6 hr (elimination half-life).
Administration
 Fusidic acid: Should be taken with food.
Storage Conditions
 Intravenous: Store below 25°C. Ophthalmic: Store between 2-25°C. Discard 1 mth after opening. Oral: Store below 25°C. Topical/Cutaneous: Store below 25°C.
ATC Classification
 D06AX01 - fusidic acid ; Belongs to the class of other topical antibiotics used in the treatment of dermatological diseases.
D09AA02 - fusidic acid ; Belongs to the class of ointment dressings with antiinfectives.
J01XC01 - fusidic acid ; Belongs to the class of steroid antibacterials. Used in the systemic treatment of infections.
S01AA13 - fusidic acid ; Belongs to the class of antibiotics. Used in the treatment of eye infections.
Storage
 Intravenous: Store below 25°C. Ophthalmic: Store between 2-25°C. Discard 1 mth after opening. Oral: Store below 25°C. Topical/Cutaneous: Store below 25°C.
Available As
  • Fusidic Acid 0.2% w/w
  • Fusidic Acid 10 mg
  • Fusidic Acid 2%
  • Fusidic Acid 2% w/w
  • Fusidic Acid 2.0%
  • Fusidic Acid 20 mg

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