Fusidic Acid: Antibiotic Treatments

• Treatments for bacterial skin infections include antibiotics, antiseptics, and other agents.
• Topical antibiotic examples are Fusidic Acid, Mupirocin, Gentamycin, Neomycin Sulfate, Bacitracin Zinc, and Polymyxin B Sulfate.
• Mupirocin and Fusidic acid are 2 commonly used antibiotics for treating superficial pyodermas and eradicating staphylococcal carrier state.

DERMOMYCIN Cream

• Contains Fusidic Acid 2% (Antibiotic) in 5gm and 15gm tube pack sizes.

Fusidic Acid History

• Fusidic acid was first isolated in 1960 from the fungus Fusidium coccineum.
• Developed for clinical use in 1962 by Leo Pharma in Denmark.

Fusidic Acid (FA) Introduction

• Fusidic Acid is an antibiotic that stops bacteria from growing.
• Fusidic Acid belongs to the Fusidane class of antibiotics.
• Fusidic Acid has a steroid-like structure but no steroid activity
• Fusidic Acid has a novel structure and mode of action, with little cross-resistance with other antibiotics.
• Fusidic Acid is used in primary and secondary skin infections caused by sensitive strains of Staph. aureus, Strep. spp., and Corynebacterium minutissimum.

Fusidane Class of Antibiotics

• Fusidane-type antibiotics are antimicrobials derived from fungi within the "Triterpene” family.
• Includes Fusidic acid, a clinically used antibiotic, to treat skin infections caused by Staphylococcus aureus
• Includes Helvolic acid, a compound with similar properties and structure to Fusidic acid.
• Includes Cephalosporin P1, a compound with similar properties and structure to Fusidic acid.

Fusidic Acid Mechanism

• Antibacterial action of Fusidic Acid inhibits bacterial protein synthesis.
• Fusidic Acid interferes with amino acid transfer from Aminoacyl-tRNA to protein on the ribosomes.
• Bacteriostatic or bactericidal depending on inoculum size.
• Bacterial cells stop dividing almost within two minutes post-contact with in vitro antibiotic.
• DNA and RNA synthesis continue for 45 minutes and 1-2 hours respectively.

Antimicrobial Spectrum of DERMOMYCIN

• Effective against Staph. aureus.
• Effective against Staph. epidermidis.
• Effective against Corynebacterium diphtheriae.
• Effective against other Corynebacterium spp. (e.g., C. minutissimum)
• Effective against Propionibacterium acnes.
• Effective against Clostridium spp.
• Fusidic acid is virtually inactive against Gram-negative bacteria, believed to be due to the difference in cell wall permeability.

DERMOMYCIN Use During Pregnancy

• Safety of Fusidic acid in treating infections during pregnancy has not been established.
• Evidence suggests the drug can penetrate the placental barrier with systemic administration.
• Weighing potential benefits against the hazard to the fetus is required during pregnancy.
• Animal studies haven't demonstrated teratogenicity with Fusidic acid.
• Topical administration of Corticosteroids to pregnant animals can cause abnormalities of fetal development.

DERMOMYCIN Use During Lactation

• Safety of Fusidic acid for treating infections in breastfeeding women has not been established.
• Fusidic acid has been detected in breast milk following systemic administration.
• Use during lactation needs the potential benefits weighed against the risks to the nursing infant.
• Application of Fusidic acid on breast is not recommended to protect nursing infants.

DERMOMYCIN Drug-Drug Interaction

• No interaction studies have been performed.
• Interactions with systemically administered medicinal products are minimal due to the negligible systemic absorption of topical Fusidic acid.

DERMOMYCIN Cream Indications

• Indicated to treat Impetigo.
• Indicated to treat Erythrasma.
• Indicated to treat Secondary skin infections.
  • Including Infected wounds.
  • Including Infected burns.

DERMOMYCIN Dosage & Application

• Apply a small amount of DERMOMYCIN Cream to the affected area 2-3 times daily for 7 days (7-14 days).
• For Acne: therapy continue for a long period; less frequent applications (1 or 2 daily) with a gauze dressing.
• Removing crusts before DERMOMYCIN Cream application is unnecessary for Impetigo.
• When required, skin lesions be incised and drained before DERMOMYCIN Cream.

DERMOMYCIN-HC Cream

• Contains Fusidic Acid 2% (Antibiotic) and Hydrocortisone Acetate 1% (Corticosteroid).
• 2 medicines work simultaneously in different ways.
• Indicated for treatment of mild to moderately severe Atopic Dermatitis (Eczema) where Staphylococcus aureus suspected as a contributing factor.
• Works by:
  • Antibiotic kills germs (bacteria) that cause infections.
  • Hydrocortisone reduces any swelling, redness, or itchiness of skin.

Hydrocortisone Introduction

• Hydrocortisone is a corticosteroid medication that treats inflammatory conditions by reducing the body's immune response.
• Treats skin conditions such as insect bites, eczema, dermatitis, allergies, rash and itching.
• Hydrocortisone reduces swelling, itching, and redness.
• Hydrocortisone long-term use can increase risk of osteoporosis and adrenal gland irregularities.

Hydrocortisone Mechanism

• Hydrocortisone acetate has anti-inflammatory, anti-pruritic, and vasoconstrictive properties.
• The anti-inflammatory activity mechanism of topical corticosteroids is unclear.
• Corticosteroids induce Phospholipase-A2 inhibitor proteins, preventing Arachidonic Acid, that's potential for inflammation.

DERMOMYCIN-HC Usage

• Apply a small amount of DERMOMYCIN-HC Cream to the affected area 2-3 times a day, generally for 7 days.
• Long-term continuous topical therapy for more than 14 days with DERMOMYCIN-HC Cream should be avoided.

Pediatric Use of DERMOMYCIN-HC

• Clinical trials with DERMOMYCIN-HC have not demonstrated any increased incidence of adverse effects in children ≥3 years.
• Pediatric patients may demonstrate greater susceptibility to topical corticosteroid induced side effects because of greater absorption.
• Excessive and prolonged usage of DERMOMYCIN-HC should be avoided.
• There's no data from clinical trials on DERMOMYCIN-HC safety and efficacy in children <3 years.

Skin Penetration of Fusidic Acid & HC

• Skin penetration by Fusidic Acid is comparable to glucocorticoids.
• 2% of the amount of topically applied Fusidic acid penetrates intact skin.
• Dermal absorption of Hydrocortisone is about 1-5% of administered dose.
• Hydrocortisone absorption is higher in areas like face, groin, axilla, on skin without a barrier, or on lesions of atopic dermatitis.

DERMOMYCIN - Superior Penetration

• DERMOMYCIN shows superior penetration compared to other antibiotics when applied topically.