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Topical fusidic acid

VOL: 101, ISSUE: 03, PAGE NO: 32

Generic/Proprietary Names

Generic/Proprietary Names
- Fusidic acid: Fucidin.

Action
- Fusidic acid is principally active against staphylococci, both Staphylococcus aureus and coagulate-negative species, which are highly susceptible.

- It is also active against Gram-positive anaerobic activity.

- Fusidic acid inhibits bacterial protein synthesis.

- Fusidic acid may be bacteriostatic or bactericidal depending on the inoculum size.

- Bacterial cells stop dividing almost within two minutes after contact with the antibiotic.

- Fusidic acid is virtually inactive against Gram-negative bacteria.

Indications
- The treatment of primary and secondary skin infections caused by strains of S. aureus, Streptococcus spp and Corynebacterium minutissimum.

- Primary skin infections include: impetigo contagiosa and erythrasma.

- Secondary skin infections such as infected wounds and burns.

Contraindications
- Sensitivity to fusidic acid and its salts, or the lanolin contained in Fucidin ointment.

Cautions
- Use of topical fusidic acid occasionally results in increased growth of non-susceptible organisms and if this occurs, or irritation develops, treatment should be discontinued and appropriate therapy instituted.

- Topical fusidic acid preparations should not be used in or near the eye because of conjunctival irritation.

Side-effects
- Mild irritation has occasionally been reported in patients with dermatoses treated with fusidic acid.

- The application of fusidic acid to deep leg ulcers has been associated with pain.

- Hypersensitivity reactions are rare.

Interactions
- In order to minimise the development of resistant organisms it is advisable to limit the choice of topical antibiotics to those not used systemically.

Administration
- Available as cream, gel or ointment.

- Apply a small amount to the lesion 3-4 times daily until results are achieved.

- If the lesion is to be covered with a dressing, less frequent applications (once or twice daily) should be used.

Nursing considerations
- If the impetigo is severe then oral antibiotics should be considered.

- Clean site with soap and water before each application.

- Children should be kept off school or nursery until treatment is under way. This may be for a day or so after treatment begins.

- There is debate about whether all impetigo should be treated with systemic antibiotics to minimise the risk of development of resistant organisms. Topical antibiotic treatment is associated with greater antibiotic resistance than systemic (oral) therapy.

- Not all skin conditions that are oozing, crusted or characterised by pustules are actually infected.

- Evaluate therapeutic response.

Patient information
- Store in a dry place.

- Store out of the reach of children.

- Clean site with soap and water before each application.

- Avoid use of other over-the-counter ointments/creams unless directed by a health care professional.

- Adhere to prescription regime to maximise outcome.

- Wash hands after applying antibiotic cream.

- Do not share towels or flannels until the infection has gone.

- Nurses should refer to manufacturer's summary of product characteristics and to appropriate local guidelines.

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