Chapter 2. Fusidic acid in skin and soft-tissue infections

"Topical antibacterial therapy is an important component in managing skin and soft-tissue infections (SSTIs). Fusi­dic acid, a narrow-spectrum antibiotic active against Staphylococcus aureus, has shown good skin permeability and low allergenic potential. The resistance rate in S. aureus remains low, as shown in a study of Canadian hospitals from 1999 to 2005. In treating primary skin infections, including impetigo, fusidic acid cream and ointment provided similar response rates and equal/better tolerability compared with other topical and oral antibiotics. Fusidic acid and mupirocin are equally or more efficacious than oral treatment in localized impetigo, and may be similarly efficacious in extensive impetigo, according to a recent Cochrane review. In clinical practice, mupirocin is often reserved for methicillin-resistant S. aureus infections. Studies of oral fusidic acid forms in SSTI have shown that: tablets are as effective as comparator anti­biotics; they have fewer side-effects; a suspension achieves high cure rates, and is suitable for paediatric use. Fusidic acid, both topical and systemic, is an effective treatment for SSTI with few adverse reactions."