Indication

Eczema, Seborrhoeic dermatitis, Atopic dermatitis with secondary Bacterial infections, Allergic dermatitis, Irritant dermatitis.

Adult Dose

Topical/Cutaneous\r\nMild to moderately severe atopic dermatitis with secondary bacterial infections\r\nAdult: As cream/ointment containing hydrocortisone 1% and fusidic acid 2%: Apply to affected area(s) bid until there is improvement. \r\nUsual treatment duration: 2 wk.\r\n

Child Dose

Topical/Cutaneous\r\nMild to moderately severe atopic dermatitis with secondary bacterial infections\r\nChild: >3 yr: As cream/ointment containing hydrocortisone 1% and fusidic acid 2%: Apply to affected area(s) bid until there is improvement. \r\nUsual treatment duration: 2 wk.

Contraindication

Hypersensitivity to fusidic acid and its salts. Bacterial infections caused by non-susceptible organisms, fungal infections, skin manifestations due to tuberculosis, syphilis, perioral dermatitis and rosacea.

Mode of Action

Hydrocortisone is a corticosteroid that has anti-inflammatory, antipruritic and vasoconstrictive effects. Fusidic acid has antibacterial action that results from the inhibition of bacterial protein synthesis; it is mainly active towards the gram-positive organisms especially Staph aureus.

Precaution

Not to be used in or near the eye(s) as it may cause conjunctival irritation; may also increase the risk of increased intraocular pressure, glaucoma and cataract. Sufficient dermal absorption may occur under occlusive dressing leading to adrenal suppression and other systemic effects. May mask hypersensitivity reactions. Not to be used for >14 days in the absence of any clinical improvement. Pregnancy and lactation.

Side Effect

Dryness, itching, burning, local irritation, transient stinging, striae, skin atrophy. Pigmentation changes, hypertrichosis and telangiectasia may occur. Acne rosacea or perioral dermatitis may occur if used on the face.

Interaction

Fusidic Acid: Synergistic action with antistaphylococcal penicillin. Antagonism with ciprofloxacin.\r\n\r\nHydrocortisone : Clearance may be increased by hepatic enzyme inducers eg phenobarb, phenytoin & rifampin. Metabolism may be inhibited by troleandomycin & ketoconazole. May increase clearance of chronic high dose aspirin. Risk of enhanced or diminished effects of anticoagulant.