Fusidate

AcrAB- TolC Tetracycline, fluoroquinolones, chloramphenicol, p-lactams except imipenem, novobiocin, erythromycin, fusidic acid, rifampicin E. coli Chromosome... 

Fusid (GRY) Lasitone (Hoechst Italia Profemin (Toa Eiyo-... 

Compound (19) is an advanced intermediate in the svnthesis of the ring system (20) of fusidic acid, a steroidal antibiotic. 

Employed as a sodium salt, fusidic acid (Fig. 5.14B) is achve against many types of Gram-positive bacteria, especially staphylococci, although streptococci are relatively resistant. It is employed in the treatment of staphylococcal infections, including strains resistant to other antibiotics. However, bacterial resistance may occur in vitro and in vivo. 

Fig. 5.14 Miscellaneous antibiotics A, chloramphenicol B, fusidic acid C, lincomycin D, clindamycin E, mupirocin (pseudomonic acid A).

Bacterial ribosome function Aminoglycosides Tetracyclines Chloramphenicol Macrolides, azalides Fusidic acid Mupirocin Distort SOS ribosomal subunit Block SOS ribosomal subunit Inhibits peptidyl transferase Block translocation Inhibits elongation factor Inhibits isoleucyl-tRNA synthesis No action on 40S subunit Excluded by mammalian cells No action on mammalian equivalent No action on mammalian equivalent Excluded by mammalian cells No action on mammalian equivalent... 

Sulphonamides Trimethoprim Chloramphenicol Erythromycin Fusidic acid sulphonamide... 

Gram-negative bacteria are intrinsically resistant to low levels of fusidic acid (a steroid) due to exclusion by the outer membrane. Nevertheless, acquired resistance does occur which has the effect of increasing the level of resistance to the antibiotic. Acquired resistance also occurs in Gram-positive bacteria normally susceptible to fusidic acid. 

Chromosomal mutations have also been described which produce a modified translocation factor protein with lowered affinity for fusidic acid. 

Sodium fusidate gauze Medicated open wound ... 

Dominguez, J. M., Gomez-Lorenzo, M. G., and Martin, J. J. (1999). Sordarin inhibits fungal protein synthesis by blocking translocation differently to fusidic arid. j. Biol. Chem. 274, 22423-22427. 

Wenisch C, Parschalk B, Hasenhundl M, Hirschl AM, Graninger W Comparison of vancomycin, teicoplanin, metronidazole, and fusidic acid for the treatment of Clostridium difficile-associated diarrhea. Clin Infect Dis 1996 22 813-818. 

Fusidic acid, bacterial resistance mechanisms, 3 32t Fusinite, 6 707t, 719, 828 Fusion, PVC, 25 663-664. See also Cold fusion Deuterium fusion Fusion-bonded-epoxies (FBE), 10 440 Fusion carburization, 4 674-675 Fusion-cast refractories, 21 504 shapes of, 21 481-482 Fusion method, for tin content assays, 24 791, 792... 

Fucicort contains fusidic acid (antibacterial) and betamethasone (corticosteroid), which is more potent than hydrocortisone (corticosteroid). Fucidin H contains fusidic acid and hydrocortisone Daktacort contains miconazole (imidazole antifungal) and hydrocortisone Canesten HC contains clotrimazole (imidazole antifungal) and hydrocortisone. Otosporin contains hydrocortisone in combination with two antibacterial agents, namely neomycin and polymyxin. 

Antibacterial treatment is generally not required in cases of gastroenteritis. Typhoid fever is treated with ciprofloxacin (quinolone), cefotaxime (third generation cephalosporin) or chloramphenicol. Impetigo necessitates the systemic use of flucloxacillin or erythromycin. Topical fusidic acid or mupirocin may also be used. 

The application of a mild topical corticosteroid, such as hydrocortisone, is effective in patients presenting with multiple mosquito bites. Paracetamol, which is an antipyretic agent is not indicated in mosquito bites. Fusidic acid cream is an anti-infective agent and is indicated if the mosquito bites have been scratched and there is risk of infection. Benzocaine (anaesthetic) and mepyramine (antihistamine) may relieve itchiness but are less effective in multiple mosquito bites than hydrocortisone. 

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