Drugs List

Therapeutic Indications

Uses

Bacterial skin infections

For use alone or in combination with systemic therapy in the treatment of primary and secondary skin infections caused by sensitive strains of Staphylococcus aureus, Streptococcus spp and Corynebacterium minutissimum.
Primary skin infections include: Impetigo contagiosa
Superficial folliculitis Sycosis barbae Paronychia Erythrasma Secondary skin infections include: Infected eczematoid dermatitis Infected contact dermatitis Infected cuts/abrasions

Dosage

Uncovered lesions Apply 3 to 4 times a day.
Covered lesions Less frequent applications may be more appropriate.

Contraindications

None known

Precautions and Warnings

Contains butyl hydroxyanisole - may cause local skin reactions
Contains cetyl alcohol - may cause local skin reactions
Avoid use in or near eyes
Extended or recurrent use may increase the risk of contact sensitisation
Length of treatment should not exceed 10 days
Resistance to the drug will build up over long term treatment
Advise patient residue on clothing/bedding may cause fire hazard
Fire hazard: Keep away from naked flames and potential sources of ignition

Pregnancy and Lactation

Pregnancy

Fusidic acid is considered safe to use in pregnancy.
The manufacturer states systemic topical exposure to fusidic acid is insignificant, therefore fusidic acid is considered safe to use during pregnancy.
The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Fusidic acid is considered safe for use in breastfeeding. The manufacturer states fusidic acid can be used during breastfeeding but recommends to avoid applying to the breasts. If fusidic acid is applied to the breast wash off thoroughly. Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Angioedema
Blisters (application site)
Conjunctivitis
Contact dermatitis
Eczema
Erythema
Hypersensitivity reactions
Irritation at application site
Pain at application site
Pruritus
Rash
Urticaria

Presentation

Topical formulations of fusidic acid

Drugs List

Therapeutic Indications

Uses

Bacterial skin infections

For use alone or in combination with systemic therapy in the treatment of primary and secondary skin infections caused by sensitive strains of Staphylococcus aureus, Streptococcus spp and Corynebacterium minutissimum.
Primary skin infections include: Impetigo contagiosa
Superficial folliculitis Sycosis barbae Paronychia Erythrasma Secondary skin infections include: Infected eczematoid dermatitis Infected contact dermatitis Infected cuts/abrasions

Dosage

Uncovered lesions Apply 3 to 4 times a day.
Covered lesions Less frequent applications may be more appropriate.

Contraindications

None known

Precautions and Warnings

Contains butyl hydroxyanisole - may cause local skin reactions
Contains cetyl alcohol - may cause local skin reactions
Avoid use in or near eyes
Extended or recurrent use may increase the risk of contact sensitisation
Length of treatment should not exceed 10 days
Resistance to the drug will build up over long term treatment
Advise patient residue on clothing/bedding may cause fire hazard
Fire hazard: Keep away from naked flames and potential sources of ignition

Pregnancy and Lactation

Pregnancy

Fusidic acid is considered safe to use in pregnancy.
The manufacturer states systemic topical exposure to fusidic acid is insignificant, therefore fusidic acid is considered safe to use during pregnancy.
The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Fusidic acid is considered safe for use in breastfeeding. The manufacturer states fusidic acid can be used during breastfeeding but recommends to avoid applying to the breasts. If fusidic acid is applied to the breast wash off thoroughly. Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Angioedema
Blisters (application site)
Conjunctivitis
Contact dermatitis
Eczema
Erythema
Hypersensitivity reactions
Irritation at application site
Pain at application site
Pruritus
Rash
Urticaria

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: March 2017

Reference Sources

Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

Joint Formulary Committee. British National Formulary. 72nd ed. London: BMJ Group and Pharmaceutical Press; 2016.

Paediatric Formulary Committee. BNF for Children 2016-2017. London: BMJ Group, Pharmaceutical Press, and RCPCH Publications; 2016.

Summary of Product Characteristics: Fucidin Cream. Leo Laboratories Limited. Revised December 2015.

US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
Available at: https://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
Last revised: 02 March 2017
Last accessed: 15 March 2017