ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Topical antibiotic (steroidal antibiotic) Pregnancy: Compatible with short-course topical use — avoid large areas or prolonged use.

Fusidic Acid 2% Cream

Brand names: Fucidin (2% cream, 2% ointment, 2% gel), Fucibet (fusidic acid 2% + betamethasone 0.1%)

Adult dose

Dose: Apply 3–4 times daily to the affected area
Route: Topical
Frequency: Three to four times daily for up to 14 days
Max: Short course only — maximum 14 days to limit resistance
Superficial skin infections (impetigo, infected eczema, folliculitis). Fucidin cream or ointment TDS–QDS for 7–14 days. Fucibet (fusidic acid + betamethasone): used for infected eczema with inflammation — short course only (7 days). CAUTION: overuse leads to fusidic acid-resistant Staphylococcus aureus (FRSA) — significant UK public health concern.

Paediatric dose

Route: Topical
Frequency: 3 times daily
Max: 7–14 days only
Concentration: 2% cream or ointment Application/ml
Safe in all ages including neonates. Short course (7–14 days) maximum. For infected neonatal skin — specialist guidance.

Dose adjustments

Renal

N/A — topical use.

Hepatic

N/A — topical use on small areas.

Clinical pearls

  • FRSA (fusidic acid-resistant S. aureus): overuse of topical fusidic acid is a major driver of resistance in UK — restrict to short courses (7–14 days maximum)
  • NICE NG190 (eczema): recommend against routine use of topical fusidic acid for infected eczema due to resistance; prefer mupirocin or systemic antibiotics for widespread infection
  • Fucibet (combined with betamethasone): useful for acutely inflamed infected eczema — but restrict to 7 days and do not repeat frequently
  • Alternative for impetigo: NICE NG153 — mupirocin preferred over fusidic acid due to lower resistance rates
  • Systemic fusidic acid (oral/IV): separate indication for staphylococcal osteomyelitis and severe skin infections — different dosing

Contraindications

  • Hypersensitivity to fusidic acid
  • Prolonged use (resistance development)

Side effects

  • Local skin irritation and burning
  • Contact dermatitis (occasional sensitisation)
  • Antibiotic resistance (Staphylococcus aureus — major concern with prolonged/repeated use)

Interactions

  • No significant systemic drug interactions at topical doses

Monitoring

  • Clinical response at 5–7 days
  • Treatment failure suggesting resistance
  • Skin sensitivity reactions

Reference: BNFc; BNF; NICE NG190 Atopic Eczema; NICE NG153 Impetigo; PHE Antimicrobial Stewardship Guidance. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways