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Resistance to fusidic acid

J Turnidge1, P Collignon

  • 1Department of Microbiology and Infectious Diseases, Women's and Children's Hospital, North Adelaide, SA, Australia. turnidgej@wch.sa.gov.au

International Journal of Antimicrobial Agents
|October 21, 1999
PubMed

Insights

Fusidic acid resistance in staphylococci is mainly due to changes in elongation factor G. While resistance can emerge during treatment, combination therapy with other agents effectively minimizes this risk.

Area of Science:

  • Microbiology
  • Molecular Biology
  • Pharmacology

Background:

  • Fusidic acid is a key antibiotic for staphylococcal infections.
  • Understanding resistance mechanisms is crucial for effective treatment strategies.
  • Staphylococcal resistance to fusidic acid can arise through various pathways.

Purpose of the Study:

  • To review the mechanisms of fusidic acid resistance in staphylococci.
  • To analyze the prevalence and trends of fusidic acid resistance.
  • To evaluate the clinical implications of fusidic acid resistance.

Main Methods:

  • Literature review of studies on fusidic acid resistance in staphylococci.
  • Analysis of resistance mechanisms including elongation factor G alterations, altered drug permeability, and efflux pumps.
  • Examination of resistance rates in various clinical settings and patient populations.

Main Results:

  • Common resistance mechanisms involve alterations in elongation factor G and plasmid-borne changes in drug permeability.
  • Most studies report low rates of fusidic acid resistance, but higher rates are observed in hospital settings with high cross-infection.
  • Methicillin-resistant Staphylococcus aureus strains show slightly higher resistance rates.
  • While in vitro and in vivo selection of resistant strains occurs, it is not frequent in clinical practice.

Conclusions:

  • Fusidic acid resistance is multifactorial, with elongation factor G alterations being the most understood mechanism.
  • Combination therapy with fusidic acid and other agents is recommended to prevent resistance emergence.
  • Continued monitoring of resistance patterns is essential for maintaining the efficacy of fusidic acid.

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