
Fusidic acid is
an antibiotic that belongs to a group of its own, the fusidanes. The molecule
has a steroid-like structure but does not possess any steroid activity. The
structure is thought to be responsible for the steroid-like high penetration,
and for the fact that no cross-resistance or cross-allergy has been seen with
other antibiotics in routine clinical use. The anti-microbial activity of
fusidic acid is specifically aimed at the most common skin pathogens, including
Staphylococcus aureus, towards which it is one of the most potent antibiotics.
The place of fusidic acid in dermatology is in the treatment of mild to
moderately severe skin and soft-tissue infections, e.g. impetigo, folicullitis,
erythrasma, furunculosis, abscesses and infected traumatic wounds, whereas it
is of less use in conditions such as hidradenitis suppurativa, chronic leg
ulcers, burns and pressure sores. The topical combinations of fusidic acid with
either betamethasone or hydrocortisone are extremely useful
in the treatment of atopic dermatitis/eczema whenever staphylococcal/secondary
infection is suspected, and in more persistent cases of eczema where
staphylococcal superantigen may be playing an important exacerbating role.
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