Fusidic Acid

No abstract available.
Dermatitis, Allergic Contact* ; Fusidic Acid* ; Sodium*

Sodium fusidate, obtained by fermentation of the fungus, Fusidium coccineum, has a steroid structure and shows a very high antitaphycoccal activity. The allergic potentirl of sodium fusidate is low and few cases of contact allergy to sodium fusidate have been reported. We present two cases of allergic contact dermatitis to Fucidin cintentione developed postoperative dressing of a skin biopsy and the other after laser treatment of a vascular nevi. The patch test results showed positive reaction to sodium fusidate in both cases.
Bandages ; Biopsy ; Dermatitis, Allergic Contact* ; Fermentation ; Fungi ; Fusidic Acid* ; Hypersensitivity ; Nevus ; Patch Tests ; Skin ; Sodium*

BACKGROUND: It is traditiqnally considered that the non-bullous fonn of impetigo is primarily of streptococcal origin and the bullous form is of staphylococcal origin. However, recent reports have shown that Staphylococcus aureus (SA) has become the predominant cauative pathogen of non-bullous impetigo as well as of bullous impetigo. Objective. Our purpose was to evaluate the predominant causativi. pathogen, and to establish a therapeutic guideline for impetigo. METHOD: We described the characteristics of lesions and gerformed bacterial culture and susceptibility tests in patients with impetigo. Patients were treatecl by one of three frequently used antibiotics(erythromycin, cefuroxime, fusidic acid). RESULTS: Of 77 patients, there were 47 cases of crusted type(61.9%), 18 cases of mixed type with crusted and bullous lesiona(23.3%), 7 cases of mixed type with crusted and pustular lesions(9.1%) and 5 cases of bullous type(6.6%). SA was grown from 90.1% af the cases, in 83.1% of cases it was the only organism to be foind and no gowth of streptococcus was faund even in mixed infections. An antimicrobial susceptibility test of 63 strains of SA demonstrated high susceptibility to vancomycin(98.4%), cefuroxime(97.1%), oxacillin(96.4%), cephalothin(95.2%), fusidic acid(91.7%) etc, and high resistance to penicillin(93.7%), gentamicin(90.5%), tobramycin(88.9%) and erythromicin(80.9%). Of 19 patients treated with erythrornycin, 12(63.1% ) showed treatment failure at a weeks, while no treatment failure occured in groups treated with cefuroxime and usidic acid. There were statistically significant differences iri therapeutic effect between cefuroxirne and erythromycin(P=0.005 by two tailedy test), and betweer fusidic acid and erythromycin(P=0.0040. But there was no significant difference between cefuroxime and fusidic acid. CONCLUSION: The predominant pathogen of non-bullous impetigo a well as bullous impetigo was SA which were highly resistant to erythromycin and highly sensitive to efuroxime and fusidic acid. In the clinical response, cefuroxinie and fusidic acid treatment were most effective and erythromycin was inadequate for treatment of impetigo.
Cefuroxime ; Coinfection ; Erythromycin ; Furosemide ; Fusidic Acid ; Humans ; Impetigo* ; Staphylococcus aureus ; Streptococcus ; Treatment Failure

BACKGROUND: Skin flap necrosis is a common complication after mastectomy and breast reconstruction. It has been proven that nitroglycerin ointment, as a topical vasodilator, can decrease the rate of skin flap necrosis after mastectomy and breast reconstruction. However, nitroglycerin can cause several side effects, including headache, dizziness, and hypotension. The purpose of this study was to evaluate whether the application of a low dose of nitroglycerin ointment reduced the rate of skin flap necrosis in breast reconstruction after skin-sparing or nipple-sparing mastectomy. METHODS: A total of 73 cases of breast reconstruction after nipple-sparing and skin-sparing mastectomy at our institution from March 2012 to January 2017 were retrospectively studied. Of these patients, 52 received nitroglycerin ointment (4.5 mg) application to the skin around the nipple-areolar complex from August 2015 to January 2017, while 21 received fusidic acid ointment from March 2012 to August 2015. The number of patients who experienced necrosis of the breast skin flap was counted in both groups. RESULTS: Skin flap necrosis developed in 2 (3.8%) patients who were treated with nitroglycerin ointment and 5 (23.8%) patients who did not receive nitroglycerin ointment treatment. Patients who did not receive nitroglycerin ointment treatment had a significantly higher risk of mastectomy skin flap necrosis than patients who did (odds ratio=7.81; 95% confidence interval, 1.38 to 44.23; P=0.02). CONCLUSIONS: Low-dose nitroglycerin ointment administration significantly decreased the rate of skin flap necrosis in patients who underwent breast reconstruction after skin-sparing or nipple-sparing mastectomy, without increasing the incidence of the side effects of nitroglycerin.
Breast* ; Dizziness ; Female ; Fusidic Acid ; Headache ; Humans ; Hypotension ; Incidence ; Mammaplasty* ; Mastectomy* ; Necrosis* ; Nitroglycerin* ; Ointments ; Retrospective Studies ; Skin*

BACKGROUND: A small subset of adolescents atopic dermatitis (AD) tends to persist. This also leads to get more antibiotics exposure with advancing years. Antibiotic resistance has been regarded as a serious problem during Staphylococcus aureus treatment, especially methicillin-resistant S. aureus (MRSA). OBJECTIVE: It was investigated the S. aureus colonization frequency in the skin lesions and anterior nares of adolescent AD patients and evaluated the changes in S. aureus antimicrobial susceptibility for years. METHODS: Patients who visited our clinic from September 2003 to August 2005 were classified into group A, and patients who visited from August 2010 to March 2012 were classified into group B. To investigate the differences with regard to patients' age and disease duration, the patients were subdivided into groups according to age. Lesional and nasal specimens were examined. RESULTS: Among the 295 AD patients, the total S. aureus colonization rate in skin lesions was 66.9% (95/142) for group A and 78.4% (120/153) for group B. No significant changes in the systemic antimicrobial susceptibilities of S. aureus strains isolated from adolescent AD patients were observed during about 10-year period. The increased trend of MRSA isolation in recent adolescent AD outpatients suggest that the community including school could be the source of S. aureus antibiotic resistance and higher fusidic acid resistance rates provides evidence of imprudent topical use. CONCLUSION: Relatively high MRSA isolation and fusidic acid resistance rates in recent AD patients suggest that the community harbors antibiotic-resistant S. aureus.
Adolescent ; Anti-Bacterial Agents ; Colon ; Dermatitis, Atopic* ; Drug Resistance, Microbial ; Fusidic Acid ; Humans ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Outpatients ; Skin ; Staphylococcus aureus* ; Staphylococcus*

BACKGROUND: The in vitro activities of retapamulin and fusidic acid against clinical isolates of mupirocin-resistant and methicillin-resistant Staphylococcus aureus (MRSA) from Korea are not well understood. OBJECTIVE: This study aimed to determine the activities of retapamulin and fusidic acid against clinical isolates of mupirocin-resistant MRSA. METHODS: Clinical isolates of mupirocin-resistant MRSA were collected from two tertiary hospitals. The minimal inhibitory concentrations of mupirocin, fusidic acid, and retapamulin were determined using agar dilution method. Polymerase chain reaction was used to confirm the identity of the species and the presence of resistance genes. Pulsed-field gel electrophoresis (PFGE) patterns of chromosomal DNA were used to determine the genetic similarity of high-level mupirocin-resistant isolates. RESULTS: Of the 497 MRSA isolates tested, 22 (4.4%) were mupirocin-resistant. Of these, 9 (1.8%) and 13 (2.6%) had high-level and low-level mupirocin resistance, respectively. Analysis of the PFGE patterns of the high-level mupirocin-resistant MRSA isolates identified five clusters. All 13 of the low-level mupirocin-resistant isolates were resistant to fusidic acid but susceptible to retapamulin. However, among the 9 high-level mupirocin-resistant isolates, 56% were resistant to fusidic acid, and all were susceptible to retapamulin. CONCLUSION: Retapamulin is highly active in vitro against Korean clinical isolates of high-level mupirocinand methicillin-resistant Staphylococcus aureus with different genetic backgrounds. Fusidic acid is more active against high-level mupirocin-resistant MRSA than low-level mupirocin-resistant MRSA.
Agar ; DNA ; Electrophoresis, Gel, Pulsed-Field ; Furosemide* ; Fusidic Acid* ; Korea ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Microbial Sensitivity Tests ; Mupirocin ; Polymerase Chain Reaction ; Tertiary Care Centers

BACKGROUND: The in vitro activities of retapamulin and fusidic acid against clinical isolates of mupirocin-resistant and methicillin-resistant Staphylococcus aureus (MRSA) from Korea are not well understood. OBJECTIVE: This study aimed to determine the activities of retapamulin and fusidic acid against clinical isolates of mupirocin-resistant MRSA. METHODS: Clinical isolates of mupirocin-resistant MRSA were collected from two tertiary hospitals. The minimal inhibitory concentrations of mupirocin, fusidic acid, and retapamulin were determined using agar dilution method. Polymerase chain reaction was used to confirm the identity of the species and the presence of resistance genes. Pulsed-field gel electrophoresis (PFGE) patterns of chromosomal DNA were used to determine the genetic similarity of high-level mupirocin-resistant isolates. RESULTS: Of the 497 MRSA isolates tested, 22 (4.4%) were mupirocin-resistant. Of these, 9 (1.8%) and 13 (2.6%) had high-level and low-level mupirocin resistance, respectively. Analysis of the PFGE patterns of the high-level mupirocin-resistant MRSA isolates identified five clusters. All 13 of the low-level mupirocin-resistant isolates were resistant to fusidic acid but susceptible to retapamulin. However, among the 9 high-level mupirocin-resistant isolates, 56% were resistant to fusidic acid, and all were susceptible to retapamulin. CONCLUSION: Retapamulin is highly active in vitro against Korean clinical isolates of high-level mupirocinand methicillin-resistant Staphylococcus aureus with different genetic backgrounds. Fusidic acid is more active against high-level mupirocin-resistant MRSA than low-level mupirocin-resistant MRSA.
Agar ; DNA ; Electrophoresis, Gel, Pulsed-Field ; Furosemide* ; Fusidic Acid* ; Korea ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Microbial Sensitivity Tests ; Mupirocin ; Polymerase Chain Reaction ; Tertiary Care Centers

Resistance to mupirocin in methicillin-resistant Staphylococcus aureus (MRSA) have increased with wide use of mupirocin in many countries, but the prevalence in Korea is not well-known. The aim of this study was to determine the prevalence, antimicrobial susceptibility, and clonality of mupirocin-resistant (MUP-R) isolates from three Korean hospitals. A total of 175 MRSA isolates were collected from three university hospitals in 2009-2010. Antimicrobial susceptibility was tested by the disk diffusion and the agar dilution methods. femA, mecA and mupA genes were detected by polymerase chain reactions. Pulsed-filed gel electrophoresis (PFGE) pattern of genomic DNA was determined after digestion with SmaI. Overall, 12 among the 175 MRSA isolates were resistant to mupirocin, with prevalence ranging from 0 to 10% depending on hospitals. Three high-level (HL) and nine low-level (LL) MUR-R isolates were obtained from two hospitals. All MUP-R isolates were susceptible to rifampin and vancomycin, but were resistant to ciprofloxacin, clindamycin, and erythromycin. Eight LL and one HL MUP-R isolates were also resistant to fusidic acid. PFGE analysis showed three HL MUP-R isolates belonged to arbitrary cluster 3, 5 and 6 with 60~90% similarity compared to LL MUP-R isolates. In conclusion, the HL resistance to mupirocin was detected in two hospitals, but HL MUP-R isolates were clonally not related.
Adenosine ; Agar ; Ciprofloxacin ; Clindamycin ; Diffusion ; Digestion ; DNA ; Electrophoresis ; Erythromycin ; Fusidic Acid ; Hospitals, University ; Korea ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mupirocin ; Polymerase Chain Reaction ; Prevalence ; Rifampin ; Vancomycin

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major pathogens of nosocomial infections. Especially in intensive care units (ICUs) and nasal carriage of Staphylococcus aureus has been known as a major risk factor of staphylococcal infections. In Korea, MRSA is the most common pathogen of nosocomial infections in ICUs. We performed this study to investigate the effects of conventional control measures and the additional effect of intranasal fusidic acid in prevention of MRSA nasal carriage and infection in ICUs of one educational hospital in Korea. METHOD: All patients admitted to medical ICU and surgical ICU in Samsung medical center from April to September 1999 were studied prospectively. Surveillance culture was done in all patients and health care workers by nasal swab culture. We tried to control MRSA infection by conventional methods in the first period April-June 1999) and by additional intranasal fusidic acid application in the second period (July-September 1999) RESULTS: Comparing the first with second periods, new nasal MRSA colonization rate among patients was significantly decreased from 14.8% to 1.8% in surgical ICU (P=0.016). Although there was no statistical difference between the first and second periods in medical ICU (14.6% vs 5.9%, P=0.192), the new nasal colonization of the first period was significantly decreased than that of the previous study which was performed in 1996 (14.6% vs 36.2%, P=0.015). And new MRSA infection rate was much more decreased than the previous study, but there was no statistical significance (11.7% vs 2.0%, P=0.066). CONCLUSION: Conventional methods for MRSA control decreased new MRSA nasal colonization of patients in ICUs. Application of intranasal fusidic acid was considered as an additional control measure for reducing MRSA nasal colonization. For evaluating effect of intranasal fusidic acid for preventing of MRSA infection in ICUs, further study with larger scale of study population is warranted.
Colon ; Cross Infection ; Delivery of Health Care ; Furosemide* ; Fusidic Acid* ; Humans ; Intensive Care Units ; Korea ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Prospective Studies ; Risk Factors ; Staphylococcal Infections ; Staphylococcus aureus