The safety record of fusidic acid in non-US markets: a focus on skin infections

Clin Infect Dis. 2011 Jun:52 Suppl 7:S527-37. doi: 10.1093/cid/cir168.

Abstract

Fusidic acid has been in clinical use outside the United States (US) since 1962 for skin infections, including methicillin-resistant Staphylococcus aureus (MRSA). Non-US labeling reflects safety concerns related to gastrointestinal, allergic, hematologic, and neurologic adverse events. We sought to survey available safety data on fusidic acid through the review of published global literature between 1962 and 2007 that contained data on oral fusidic acid safety and a centralized database (VigiBase) of spontaneous safety reports. Overall, the data were concordant with current product labeling, and no serious adverse events, such as death, hospitalization, or hepatotoxicity, were convincingly linked to fusidic acid monotherapy in skin infection patients. Other indications for fusidic acid use were also common, including osteomyelitis with similar reporting of labeled safety characteristics. Study quality was highly varied with limited structure to safety data collection methodology. Significant concerns for recall bias are present, yet these data remain informative in providing signals that require attention in the design and conduct of adequate and well-controlled clinical studies of fusidic acid for potential registration in the United States.

Publication types

  • Review

MeSH terms

  • Adverse Drug Reaction Reporting Systems
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / therapeutic use
  • Databases, Factual
  • Drug Labeling*
  • Fusidic Acid / administration & dosage
  • Fusidic Acid / adverse effects*
  • Fusidic Acid / therapeutic use
  • Humans
  • Internationality
  • Randomized Controlled Trials as Topic
  • Skin Diseases, Infectious / drug therapy*
  • Skin Diseases, Infectious / microbiology

Substances

  • Anti-Bacterial Agents
  • Fusidic Acid