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Antibiotic — Fusidane (Ophthalmic) Pregnancy: Safe for topical use — used routinely in pregnancy

Fusidic Acid Eye Drops 1% (Viscous)

Brand names: Fucithalmic

Adult dose

Dose: 1 drop twice daily
Route: Topical (ophthalmic)
Frequency: Twice daily for 5–7 days
Max: 1 drop twice daily
Viscous formulation provides extended contact time despite twice-daily dosing — patient compliance advantage. Particularly active against Staphylococcus aureus (MSSA) including MRSA strains in some studies. First-line choice for bacterial conjunctivitis in UK primary care (NICE).

Paediatric dose

Route: Topical
Frequency: Twice daily
Max: Same as adult
Safe for use in infants and children — first-line for paediatric bacterial conjunctivitis in UK

Dose adjustments

Renal

No adjustment — topical only

Hepatic

No adjustment

Clinical pearls

  • NICE recommended first-line for bacterial conjunctivitis in UK primary care — twice-daily dosing and well-tolerated in all age groups from neonates to elderly
  • Activity against MRSA: fusidic acid has activity against some MRSA strains — important for ocular MRSA infections (post-operative, contact lens-associated); however, clinical MRSA resistance to fusidic acid is increasing
  • Viscous delivery system: the 1% viscous suspension has prolonged ocular contact time compared to aqueous drops — equivalent or superior efficacy to four-times-daily chloramphenicol
  • Does NOT cover Pseudomonas: fusidic acid has no activity against Gram-negative organisms including Pseudomonas — not appropriate for contact lens wearers with keratitis; use ciprofloxacin or tobramycin instead
  • Neonatal conjunctivitis: gonococcal ophthalmia neonatorum requires urgent IV/IM ceftriaxone — fusidic acid is INADEQUATE; chlamydial neonatal conjunctivitis requires oral azithromycin or erythromycin

Contraindications

  • Hypersensitivity to fusidic acid
  • Contact lenses during treatment (remove; wait 15 minutes)

Side effects

  • Transient blurring on instillation (viscous formulation)
  • Burning and stinging
  • Local hypersensitivity — itching, redness

Interactions

  • No clinically significant systemic interactions from topical use

Monitoring

  • Response at 5 days
  • If no response in 48 hours — consider viral aetiology or unusual pathogen

Reference: BNFc; BNF 90; NICE Guidance (Conjunctivitis); Public Health England Guidance; SPC Fucithalmic. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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