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Published on: November 11, 2018

Presumed interaction of fusidic acid with simvastatin

A J Burtenshaw1, G Sellors, R Downing

  • 1Anaesthesia & Intensive Care Medicine, Worcestershire Royal Hospital, Charles Hastings Way, Newtown Road, Worcester WR5 1DD, UK. andrew_burtenshaw@doctors.org.uk

Anaesthesia
|May 15, 2008
PubMed

Insights

Fusidic acid, prescribed for methicillin-resistant Staphylococcus aureus (MRSA) infection, likely caused severe rhabdomyolysis by interacting with simvastatin. This drug interaction highlights potential risks with increasing antibiotic and statin use.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • A 63-year-old male underwent abdominal aortic aneurysm repair.
  • Post-operatively, methicillin-resistant Staphylococcus aureus (MRSA) was cultured from the aneurysmal sac.

Observation:

  • The patient received fusidic acid and simvastatin upon discharge.
  • Within four weeks, he developed symptoms indicative of severe rhabdomyolysis.
  • Despite intensive critical care, treatment was unsuccessful.

Findings:

  • Investigations ruled out other causes for rhabdomyolysis.
  • The likely cause identified was fusidic acid inhibiting the CYP3A4 enzyme.
  • This inhibition led to elevated simvastatin levels and subsequent myocellular damage.

Implications:

  • This case suggests a potential drug interaction between fusidic acid and statins (specifically simvastatin) via CYP3A4 inhibition.
  • Increased rates of MRSA infections and widespread statin use may lead to a rise in such adverse events.
  • Clinicians should exercise caution when prescribing fusidic acid to patients on statin therapy.

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