Fusidic Acid Eye Drops 1% (Viscous)

How it works

Fusidic acid inhibits bacterial protein synthesis by interfering with elongation factor G, and the viscous gel-forming vehicle prolongs ocular surface contact time, allowing twice-daily application rather than frequent dosing.

Prescribing in practice

• Its antibacterial spectrum is relatively narrow and chiefly Gram-positive, so it is not appropriate when a Gram-negative or atypical pathogen is suspected and should be reconsidered if there is no clinical response.
• Soft contact lenses should be removed before instillation and not worn during treatment of an acute infection.
• Transient blurring on instillation is expected because of the viscous formulation.

Monitoring

Monitoring is clinical, reviewing resolution of discharge and redness and reconsidering the diagnosis or pathogen if symptoms fail to improve within a few days.

Counselling the patient

• Vision may blur briefly after each drop because the formulation is thick.
• Do not wear soft contact lenses while treating the infection.
• Complete the prescribed course even if the eye looks better and avoid sharing towels or eye products.

Evidence & guidelines

Topical fusidic acid is a recognised option for bacterial conjunctivitis, though many cases of acute infective conjunctivitis are self-limiting, consistent with NICE guidance on conservative initial management.