Gram-positive: Staphylococcus spp. C. difficile, C. perfringens, Peptostreptococcus spp., Propionibacterium acnes; Gram-negative: Neisseria spp.; Other: Mycobacterium spp.
Inhibition of protein synthesis via interfering with elongation factor G
Cmax: 52.4 mg/L; Half-life: 9.8 (hr); Total Clearance: 21 ml/min; Volume of distribution: 0.3 L/kg; Table 2
Hematologic: granulocytopenia, thrombocytopenia
GI: hepatotoxicity, nausea, vomiting, abdominal pain, diarrhea,
Tablets: 250, 500mg
IV: 500mg vial
Adults: 250 – 500mg PO or IVq8 to q12 hours
Children: 12mg/kg up to 500mg IV q 12 hours or 20mg/kg/day divided q 8 hours
Renal failure: Dosing adjustments not necessary
Hepatic failure: No official recommendations exist, but avoidance in patients with severe liver disease may be warranted.
Precautions: Use caution in patients with jaundice/hepatic dysfunction
Fusidic acid is metabolized in the liver and CYP 450 enzyme interactions have been reported.
Ritonavir and Saquinavir: inhibition of metabolism and increased fusidic acid levels
Cholestyramine: binds fusidic acid and decreases bioavailability
Category C: Risk unknown. Human studies inadequate.
Therapeutic: Culture and sensitivities, signs and symptoms of infection
Toxic: LFTs should be monitored in intravenous or prolonged therapy