This cream combines the potent topical antibacterial activity of fusidic acid with the anti-inflammatory and anti-pruritic activity of the moderately potent corticosteroid betamethasone valerate. When applied topically, fusidic acid is effective against Staphylococci, Streptococci, Corynebacteria, Neisseria and certain Clostridia and Bacteroides. The antibacterial activity of fusidic acid is not diminished in the presence of betamethasone.

Pharmacology

Fusidic acid is only effective against gram-positive bacteria such as Streptococcus, Staphylococcus aureus and Corynebacterium minutissimum. The antibacterial action of fusidic acid results from inhibition of bacterial protein synthesis. The drug interferes with amino acid transfer from aminoacyl-tRNA to protein on the ribosomes. Betamethasone induces lipocortin which inhibits phospholipase A-2 enzyme which results in the inhibition of different inflammartory mediators synthesis like prostaglandins, cinins, histamines.

Pharmacokinetics: Fusidic acid can penetrate intact human skin. As much as 2% of the amount of topically applied fusidic acid penetrates intact skin. The degree of penetration depends on factors such as the duration of exposure to fusidic acid and the condition of the skin. Fusidic acid is excreted mainly in the bile with little excreted in the urine. Dermal absorption and potency of any topical corticosteroid including betamethasone depends on the vehicle in which the steroid is delivered. Absorption of betamethasone may be higher in certain body areas such as the face, groin, axilla, or on injured or inflamed skin such as the lesions of atopic dermatitis.

This cream is indicated in eczema and dermatitis with secondary infections including atopic dermatitis, allergic and seborrhoeic dermatitis and primary irritant dermatitis.

Adults: It should be applied 2 times daily and gently massaged into the affected areas for 2 weeks. A shorter course should be considered if symptoms improve.

Children: It is not recommended in children under 3 years of age.

Topical hydrocortisone is contraindicated in viral tuberculosis and fungal skin infections. Hypersensitivity to any of the components.

Possible side effects are allergic reactions, headache, skin rash, redness or itching, unusual tiredness or weakness, yellow eyes or skin.

Long term continuous therapy should be avoided, particularly in the face, on flexures and intertriginous areas and in infants and children.

Pregnancy & Lactation

Fusidic acid and betamethasone should not be used in pregnancy. Both of them have been detected in the breast milk, so nursing mothers are advised not to use the drug.