[01] Kumurya A. S., Department of Medical Laboratory Science, Faculty of Allied Health Sciences, Bayero University, Kano, Nigeria.

Fusidic acid has a high degree of activity against Staphylococcus aureus, including methicillin resistant Staphylococcus aureus (MRSA). Overall, among the 423 MRSA isolates collected from consecutive patients (8 hospitals; 6 states in North-western Nigeria), the mean rate of fusidic acid resistance was 4.9%. Fusidic acid monotherapy, especially topical preparations, has been strongly associated with the emergence of fusidic acid resistance among both methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S. aureus (MSSA). Key resistance determinants include mutations in the fus A gene, which encodes elongation factor G, and plasmid-mediated resistance (i.e., acquisition of resistance gene fus B). Clonal outbreaks of fusidic acid–resistant S. aureus have been noted in some part of the world, such that the efficacy of fusidic acid is threatened. Fusidic acid in combination with other agents, such as rifampicin, has proven effective for difficult-to-treat MRSA infections and provides a convenient oral alternative to oxazolidinones. Ensuring that systemic fusidic acid is always used in combination and that the use of topical fusidic acid is either abolished or restricted will be crucial if we are to prevent the loss of this potentiallyuseful agent.Given current trends regarding the spread and clinical impact of hospital- and community-acquired MRSA infection, it would seem to be judicious to maintain all possible treatment options, including the potential use of fusidic acid. The information gained from the epidemiology of fusidic acid resistant isolates can help the hospitals infection control teams understand the epidemiology of these organisms in their institutions.

Fusidic Acid, Staphylococcus aureus, MRSA, Monotherapy, Resistance

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