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Published on: March 31, 2022
Fusidic Acid and Its Major Active Metabolite Penetration into Cerebrospinal Fluid for Assessing Treatment of
Zhi Rao1, Zhong-Fang He2, Mao-Hua Zheng3
1Department of Pharmacy, The First Hospital of Lanzhou University, Lanzhou, China, caesar-731@163.com.
Abstract:
Fusidic acid (FA) had excellent antimicrobial effects due to its unique mechanism of action. Since 1962, FA has been widely used in the systemic and topical treatment of staphylococcal infections and exhibits a well-characterized potency against methicillin-susceptible Staphylococcus aureus, methicillin-resistant Staphylococcus aureus, and methicillin-resistant coagulase-negative Staphylococci. In view of the spectrum of activity, no cross-resistance with other clinically used antibiotics, and potential penetration into brain tissue, FA was used to treat possible gra-positive bacteria in 3 patients with intracranial infections in the present report. FA and its active metabolite (3-keto FA) were measured in plasma and cerebrospinal fluid (CSF) to assess the treatment of FA, and the results indicated that 1,500 mg per day of FA was sufficient to achieve therapeutic concentrations in both plasma and CSF in intracranial infection patients, while the dosage did not experience unexpected regimen-related toxicity.
Insights
Fusidic acid (FA) effectively treats staphylococcal infections, including brain infections. A daily dose of 1,500 mg achieved therapeutic levels in plasma and cerebrospinal fluid without toxicity.
Area of Science:
- Pharmacology
- Infectious Diseases
- Neuroscience
Background:
- Fusidic acid (FA) is a potent antibiotic with a unique mechanism of action, effective against various Staphylococcus strains since 1962.
- FA demonstrates efficacy against methicillin-susceptible and resistant Staphylococcus aureus and coagulase-negative Staphylococci.
- Its activity spectrum, lack of cross-resistance, and potential for brain tissue penetration make it a candidate for central nervous system infections.
Observation:
- This report details the use of FA in three patients with intracranial infections caused by Gram-positive bacteria.
- Plasma and cerebrospinal fluid (CSF) concentrations of FA and its metabolite (3-keto FA) were monitored to evaluate therapeutic efficacy.
- The study assessed the safety and effectiveness of FA for treating central nervous system infections.
Findings:
- A daily dosage of 1,500 mg of FA was found to be sufficient for achieving therapeutic concentrations in both plasma and CSF in patients with intracranial infections.
- The administered dosage of FA did not result in any unexpected regimen-related toxicity.
- FA demonstrated the potential for effective treatment of Gram-positive bacterial intracranial infections.
Implications:
- FA can be a viable therapeutic option for managing staphylococcal intracranial infections.
- The findings support the use of FA in neuro-infectious disease treatment protocols.
- Further research into FA's role in treating central nervous system infections is warranted.
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