Topical mild steroid + antibacterial Pregnancy: Can be used during pregnancy if clinically needed - no effects are anticipated from fusidic acid (systemic exposure negligible), and a large amount of data on pregnant women (more than 1000 pregnancy outcomes) indicates no malformative or feto/neonatal toxicity of corticosteroids; however, based on general knowledge about systemic corticosteroids, caution should be exercised. Breast-feeding: can be used, but it is recommended to avoid applying to the breast. Fertility: no clinical studies.

Hydrocortisone with fusidic acid

Brand names: Fucidin H

Used in: Anaphylaxis & Allergy Acute Red Eye

This combination cream contains the mild corticosteroid hydrocortisone with the antibacterial fusidic acid, used for inflammatory dermatoses such as eczema with secondary bacterial (predominantly staphylococcal) infection.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: Uncovered lesions: a small quantity applied to the affected area twice daily until a satisfactory response is obtained. Covered lesions: less frequent applications may be adequate

Route: Topical (cream) - apply to the affected area of skin

Frequency: Twice daily for uncovered lesions; less frequent applications may be adequate for covered lesions

Max: A single treatment course should not normally exceed 2 weeks (§4.2). §4.4 adds that limiting therapy with topical fusidic acid and hydrocortisone acetate to no more than 14 days at a time will minimise the risk of developing antibiotic resistance, and that steroid-antibiotic combinations should not be continued for more than 7 days in the absence of any clinical improvement

Source: UK SPC for Fucidin H Cream (fusidic acid with hydrocortisone acetate) - product, route and indication all match this page, and it covers BOTH components of the combination. §4.2 gives one combined recommendation for Adults and Children, with no separate paediatric regimen and no per-kg dose, hence paedDose is null; use with care in children, as paediatric patients may be more susceptible to topical corticosteroid-induced HPA-axis suppression and Cushing syndrome than adults (§4.4). Long-term continuous topical therapy should be avoided, and possible systemic absorption of hydrocortisone acetate should always be considered depending on the application site. Use with care near the eyes and avoid getting the cream into the eyes; avoid contact with open wounds and mucous membranes; avoid prolonged use on the face. Switch to systemic therapy if infection cannot be controlled with topical treatment. Excipients butyl hydroxyanisole, cetyl alcohol, potassium sorbate and polysorbate 60 may cause local skin reactions or allergic reactions. Instruct patients not to smoke or go near naked flames - risk of severe burns (fabric warning truncated in the fetched text). NOTE ON US LABEL: the openFDA record in this bundle is an OTC single-ingredient hydrocortisone anti-itch product (apply not more than 3 to 4 times daily) - it does not describe this fixed combination and was NOT used.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to fusidic acid/sodium fusidate, hydrocortisone acetate or to any of the excipients
Primary skin infections caused by fungi, virus or bacteria, either untreated or uncontrolled by appropriate treatment
Skin manifestations in relation to tuberculosis, either untreated or uncontrolled by appropriate therapy
Perioral dermatitis and rosacea

Side effects

Application site reaction, including pruritus, burning and irritation (common)
Hypersensitivity (uncommon)
Contact dermatitis, eczema (condition aggravated), rash (uncommon)
Blurred vision (frequency not known)
Withdrawal reactions - redness of the skin which may extend beyond the initially affected area, burning or stinging sensation, itch, skin peeling, oozing pustules (frequency not known)
Class effects of mild corticosteroids: adrenal suppression with prolonged topical use; raised intra-ocular pressure and glaucoma after use near the eyes; skin atrophy, striae, telangiectasia, rosacea, erythema, depigmentation, hypertrichosis, hyperhidrosis and ecchymosis

Clinical monograph

How it works

Hydrocortisone reduces cutaneous inflammation via glucocorticoid receptors, while fusidic acid inhibits bacterial protein synthesis by blocking elongation factor G.

Prescribing in practice

Restrict to short courses for infected inflammatory skin to reduce fusidic acid resistance and avoid steroid-related skin thinning; it is not for infection or inflammation alone.
Activity is mainly against Gram-positive organisms, particularly Staphylococcus aureus.
Avoid prolonged or repeated use on the face and flexures.

Monitoring

Review the response within a few days; reassess and consider swabs if the infected eczema fails to improve.

Counselling the patient

Apply thinly to affected areas for the short course only and do not keep leftover cream.
Wash hands after application unless treating the hands.
Return if the area worsens or has not cleared after the prescribed course.

Evidence & guidelines

NICE antimicrobial stewardship guidance supports short-course topical fusidic acid use to limit resistance in infected dermatoses.

Reference: NICE CG57; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways