Fusidic acid for the treatment of bone and joint infections caused by meticillin-resistant Staphylococcus aureus

Int J Antimicrob Agents. 2012 Aug;40(2):103-7. doi: 10.1016/j.ijantimicag.2012.03.010. Epub 2012 May 20.


There is a lack of surveillance data on resistance to fusidic acid (FA) in Asia, and no reviews of FA usage for the treatment of orthopaedic infections have been conducted since the year 2000. In this study, we present a systemic literature review of FA resistance in Asia and the clinical use of FA for the treatment of bone and joint infections (BJIs). The in vitro activity of FA against meticillin-resistant Staphylococcus aureus (MRSA) isolates remains good, with low (<10%) resistance rates in most Asian countries. FA in Asia appears to be a better oral anti-MRSA agent than trimethoprim/sulfamethoxazole and clindamycin. More than 80 cases of FA use for BJI have been reported since 2000 and the recurrence or failure rate is <10%. There is much evidence supporting the use of FA in combination with other antibiotics (e.g. rifampicin) as an oral treatment following intravenous glycopeptide treatment for BJIs.

Publication types

  • Review

MeSH terms

  • Acetamides / administration & dosage
  • Acetamides / therapeutic use
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Asia
  • Bone Diseases, Infectious / drug therapy*
  • Bone Diseases, Infectious / epidemiology
  • Bone Diseases, Infectious / microbiology
  • Doxycycline / administration & dosage
  • Doxycycline / therapeutic use
  • Drug Resistance, Bacterial
  • Fusidic Acid / administration & dosage
  • Fusidic Acid / therapeutic use*
  • Humans
  • Joint Diseases / drug therapy*
  • Joint Diseases / epidemiology
  • Joint Diseases / microbiology
  • Linezolid
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • Methicillin-Resistant Staphylococcus aureus / pathogenicity
  • Microbial Sensitivity Tests
  • Oxazolidinones / administration & dosage
  • Oxazolidinones / therapeutic use
  • Staphylococcal Infections / drug therapy*
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology


  • Acetamides
  • Anti-Bacterial Agents
  • Oxazolidinones
  • Fusidic Acid
  • Linezolid
  • Doxycycline