Fusidic acid
Brand names: Fucidin, Fucibet (with steroid)
Fusidic acid (and its salt sodium fusidate) is a narrow-spectrum antibiotic active mainly against staphylococci, used topically for skin and eye infections and systemically for certain staphylococcal infections, often as part of combination therapy.
Adult dose
Paediatric dose
Dose adjustments
Not stated — no renal-impairment statement appears in any fetched section of this SPC. §4.5 notes that 'the systemic absorption of topical Fucidin is negligible', but no dosing consequence is drawn from that for renal impairment.
Not stated — no hepatic-impairment statement appears in any fetched section of this SPC. (The hepatotoxicity the page lists relates to SYSTEMIC fusidic acid / sodium fusidate, which this topical SPC does not cover.)
Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via the eMC — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.
Contraindications
- Hypersensitivity to the active substance or to any of the excipients listed in section 6.1 — §4.3, and the ONLY contraindication stated in this SPC.
Side effects
- Overall frequency (§4.8 verbatim): 'Based on pooled data from clinical studies including 4724 patients who received Fucidin cream or Fucidin ointment, the frequency of undesirable effects is 2.3%.'
- Dermatitis (including dermatitis contact, eczema) — Uncommon, ≥1/1,000 and <1/100 (§4.8)
- Rash — Uncommon (§4.8). 'Various types of rash reactions such as erythematous, pustular, vesicular, maculo-papular and papular have been reported. Rash generalised has also occurred.'
- Pruritus — Uncommon (§4.8)
- Erythema — Uncommon (§4.8)
- Application site pain (including skin burning sensation) — Uncommon (§4.8)
- Application site irritation — Uncommon (§4.8)
- Hypersensitivity — Rare, ≥1/10,000 and <1/1,000 (§4.8)
- Conjunctivitis — Rare (§4.8)
- Angioedema — Rare (§4.8)
- Urticaria — Rare (§4.8)
- Blister — Rare (§4.8)
Monitoring
- No routine laboratory or clinical monitoring requirement is stated anywhere in this topical SPC. (The LFT monitoring the page lists applies to SYSTEMIC fusidic acid, which this source does not cover.)
- §4.4: watch for emerging bacterial resistance — 'Bacterial resistance among staphylococcus aureus has been reported to occur with the use of topical Fucidin. As with all antibiotics, extended or recurrent use may increase the risk of developing antibiotic resistance.'
- §4.4: watch for contact sensitisation — 'Extended or recurrent use may increase the risk of developing contact sensitisation.'
- §4.4: use with care near the eyes — the butylhydroxyanisole excipient 'may also cause irritation to the eyes and mucous membranes'.
Clinical monograph
How it works
It inhibits bacterial protein synthesis by binding elongation factor G and preventing its release from the ribosome, halting the translocation step of peptide chain elongation.
Prescribing in practice
- Resistance can emerge rapidly, so for systemic staphylococcal infection it is generally combined with another antistaphylococcal agent rather than used alone.
- Systemic use can cause hepatic dysfunction and jaundice, and may interact with statins to increase the risk of myopathy and rhabdomyolysis.
- Reserve topical use for short, defined courses to limit resistance, in line with the SPC and current prescribing references.
Monitoring
With systemic therapy monitor liver function tests, particularly with prolonged or higher-intensity treatment and in patients with hepatic impairment.
Counselling the patient
- Complete the prescribed course and use topical preparations only for the short period advised.
- Report yellowing of the skin or eyes, or unexplained muscle pain or weakness, promptly.
- Tell your prescriber if you take a statin, as the combination may need to be avoided.
Evidence & guidelines
UK guidance supports combination therapy to reduce resistance when fusidic acid is used systemically against staphylococci, and the MHRA has highlighted the interaction with statins.
Reference: MHRA Drug Safety Update (statin interaction); 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).
Related
Curated clinical cross-links plus same-class fallbacks.
- Steroid Dose Equivalence · Medications
- Adrenal Crisis Risk Score · Adrenal Disorders
- Centor / McIsaac Score for Strep Pharyngitis · Throat
- Acute Otitis Media — Antibiotic or Observation (AAP 2013) · Otitis Media
- Lille Model (Steroid Response in Alcoholic Hepatitis) · Alcoholic Liver Disease
- Ho Index — Acute Severe Ulcerative Colitis · Inflammatory Bowel Disease
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023