An antibiotic isolated from the fermentation broth of Fusidium coccineum. It acts by inhibiting translocation during protein synthesis.Fusidic acid is active in vitro against Staphylococcus aureus, most coagulase-positive staphylococci, Beta-hemolytic streptococci, Corynebacterium species, and most clostridium species. Fusidic acid has no known useful activity against enterococci or most Gram-negative bacteria (except Neisseria, Moraxella, Legionella pneumophila, and Bacteroides fragilis). Fusidic acid is active in vitro and clinically against Mycobacterium leprae but has only marginal activity against Mycobacterium tuberculosis.
Mechanism of Action of Fusidate sodium
Fusidic acid acts as a bacterial protein synthesis inhibitor by preventing the turnover of elongation factor G (EF-G) from the ribosome. Fusidic acid is effective primarily on gram-positive bacteria such as Staphylococcus species, Streptococcus species,and Corynebacterium species. Fusidic acid inhibits bacterial translation and does not kill the bacteria, and is therefore termed “bacteriostatic”.
Fusidic acid is a steroid antibiotic, derived from the fungus Fusidium coccineum and was developed by Leo Pharma in Ballerup, Denmark and released for clinical use in the 1960s. It has also been isolated from Mucor ramannianusand Isaria kogana. The drug is licensed for use as its sodium salt sodium fusidate, and it is approved for use under prescription in South Korea, Japan, UK, Canada, Europe, Australia, New Zealand, Thailand, India and Taiwan. A different oral dosing regimen, based on the compound’s pharmacokinetic/pharmacodynamic (PK-PD) profile is in clinical development in the U.S.as Taksta.
Indications of Fusidate sodium
- Osteomyelitis
- Conjunctivitis, Bacterial
- Mild Atopic dermatitis
- Moderate Atopic dermatitis
- Cutaneous infections
- Inflammation of hair follicles
- Bone infections
- Dermatological infections
- Skin infections
- Sodium Fusidate may also be used for purposes not listed here.
- Bacterial infections
- Upper respiratory tract infection
- A dental abscess
- Bacterial endocarditis prevention
- Skin or soft tissue infection
- Bartonellosis
- Bowel preparation
- Bronchitis
- Intestinal amebiasis caused by Entamoeba histolytica
- Skin infection
- Ophthalmia neonatorum (gonococcal)
Contraindications of Fusidate sodium
- Allergic reactions
- Breastfeeding
- Pregnant
Dosages of Fusidate sodium
Strengths: 250mg, 500mg
For staphylococcal cutaneous infections:
| Adults: | Standard Dose: 250mg (one tablet) sodium fusidate (equivalent to 240mg fusidic acid) twice daily for 5-10 days. |
For staphylococcal infections such as osteomyelitis, pneumonia, septicemia, wound infections, endocarditis, superinfected cystic fibrosis.
| Adults: | Standard dose: 500mg (two tablets) sodium fusidate (equivalent to 480mg fusidic acid) three times daily. |
In severe cases of fulminating infections, the dosage may be doubled or appropriate combined therapy may be used.
Elderly: No dosage alterations are necessary in the elderly.
Side Effects of Fusidate sodium
The most common
- allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
- leukopenia/leukemia
- hemolytic anemia
- serum sickness
- agranulocytosis
- pain, swelling, irritation where injected
- stomach upset
- sweating
- skin color change, mild diarrhea
- mild nausea
- loss of appetite
- vaginal discharge and itching
- swelling of feet or legs
- chest pain
- constipation
- cough
- diarrhea or loose stools
- difficulty with breathing
- dizziness
- heartburn
More common
- Abdominal or stomach pain, discomfort, or tenderness
- chills or fever
- difficulty with moving
- headache, severe and throbbing
- joint or back pain
- muscle aching or cramping
- muscle pains or stiffness
- chest pressure or squeezing pain in chest
- excessive sweating
- feeling of heaviness, pain, warmth and/or swelling in a leg or in the pelvis
- sudden tingling or coldness in an arm or leg
- sudden slow or difficult speech
- sudden drowsiness or need to sleep
- fast breathing
- sharp pain when taking a deep breath
- fast or slow heartbeat
- coughing up blood
- rust colored urine
- decreased amount of urine
Rare
- Anxiety
- change in vision
- seizures
- abnormal or fast heart rate
- tremors
- weight loss
- chest pain or tightness
- confusion
- cough
- Agitation
- arm, back, or jaw pain
- blurred vision
- chest pain or discomfort
- convulsions
- extra heartbeats
- fainting
- hallucinations
- headache
- irritability
Drug Interactions of Fusidate sodium
- “statins” (e.g., atorvastatin, lovastatin, rosuvastatin, simvastatin)
- penicillins (e.g., penicillin, amoxicillin)
- protease inhibitors (e.g., atazanavir, indinavir, lopinavir, ritonavir, saquinavir)
- Atorvastatin Pravastatin Ritonavir Saquinavir Simvastatin
Fusidic acid should not be used with quinolones, with which they are antagonistic. When combined with rifampicin, the action of fusidic acid is additive or synergistic.
It has been reported on August 8, 2008, that the Irish Medicines Board was investigating the death of a 59-year-old Irish man who developed rhabdomyolysis after combining atorvastatin and Fusidic Acid, and three similar cases. In August 2011, the UK’s Medicines and Healthcare products Regulatory Agency issued a Drug Safety Update warning that “Systemic fusidic acid (Fucidin) should not be given with statins because of a risk of serious and potentially fatal rhabdomyolysis. “
Pregnancy & Lactation of Fusidate sodium
Pregnancy
This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Lactation
This medication may pass into breast milk. If you are a breastfeeding mother and are using fusidic acid, it may affect your baby. Talk to your doctor about whether you should continue breastfeeding.
References
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