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Fusidic Acid

Drugs and Chemicals · NLM MeSH · updated 2026-10-31 · version 1

Citations verified against PubMedNot yet clinician-reviewed10 referencesApproximately 4 min read

An antibiotic isolated from the fermentation broth of Fusidium coccineum.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 4 complete abstracts (707 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

An antibiotic isolated from the fermentation broth of Fusidium coccineum. (From Merck Index, 11th ed). It acts by inhibiting translocation during protein synthesis.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Acid, Fusidic; Silver Fusidate; Fusidate, Silver; Stanicide; Fusidin; Fucithalmic; Fusidate Sodium; Sodium, Fusidate.

Where it fits in the MeSH classification

Broader topics
Cholestadienols; Sterols

Research landscape

PubMed indexes 1,743 records tagged with the MeSH heading “Fusidic Acid” (counts retrieved 2026-10-31). 127 of them (7.3%) were published from 2020 onward, and the busiest period so far is through 1999 with 1,030 records.

Reviews account for 100 records (5.7%) and meta-analyses for 6. Randomized controlled trials number 78 (4.5%) as a share of all records on the topic.

PubMed records by publication periodthrough 1999: 1,030 records; 2000-2009: 280 records; 2010-2019: 306 records; 2020 onward: 127 records1,030through 19992802000-20093062010-20191272020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 19991,030
2000-2009280
2010-2019306
2020 onward127
Share of records by publication typeReviews: 5.7 percent; Meta-analyses: 0.3 percent; Randomized controlled trials: 4.5 percentReviews5.7% (100)Meta-analyses0.3% (6)Randomized controlled trials4.5% (78)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 1,743 PubMed records
TypeRecordsShare
Reviews1005.7%
Meta-analyses60.3%
Randomized controlled trials784.5%

Method: PubMed query "Fusidic Acid"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.

Reading the evidence in drugs and chemicals

Studies of a chemical or drug can answer very different questions: what it is and how it behaves in cells and animals, how the body handles it, and whether it changes outcomes in people. Laboratory and animal findings often do not carry over to patients, and observational studies of exposures are confounded by who uses a substance and why. Nothing on this page is a recommendation to use, avoid, start or stop any substance or medicine; talk to a qualified clinician or pharmacist about your own situation. Check the dose, the species, the comparison group and whether a patient-relevant outcome was measured.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Biosynthesis of helvolic acid and identification of an unusual C-4-demethylation process distinct from sterol biosynthesis
Lv JM, Hu D, Gao H, Kushiro T, Awakawa T, Chen GD, et al.
2017Research article
Design not recorded in structured metadata
76cc by
PMID 29158519 · DOI · PMC5696383
Transport of lipophilic carboxylates is mediated by transmembrane helix 2 in multidrug transporter AcrB
Oswald C, Tam HK, Pos KM
2016Research article
Design not recorded in structured metadata
63cc by
PMID 27982032 · DOI · PMC5171871
The global prevalence of fusidic acid resistance in clinical isolates of Staphylococcus aureus: a systematic review and meta-analysis
Hajikhani B, Goudarzi M, Kakavandi S, Amini S, Zamani S, van Belkum A, et al.
2021Meta-analysis
Design not recorded in structured metadata
42cc by
PMID 33933162 · DOI · PMC8088720
Bacteriophage and Fusidic Acid Have Synergistic Effect Against Meticillin-Resistant Staphylococcus pseudintermedius in Ex Vivo Canine Dermis Model
Ehling S, Peh E, Oltmanns H, Meissner J, Kittler S, Puff C, et al.
2026Research article
Design not recorded in structured metadata
1cc by
PMID 40968468 · DOI · PMC12967880

Biosynthesis of helvolic acid and identification of an unusual C-4-demethylation process distinct from sterol biosynthesis [1]

Research article Lv JM, Hu D, Gao H, Kushiro T, Awakawa T, Chen GD, et al. · · 2017 · cited 76 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Fusidane-type antibiotics represented by helvolic acid, fusidic acid and cephalosporin P1 are a class of bacteriostatic agents, which have drawn renewed attention because they have no cross-resistance to commonly used antibiotics.
Closing excerpt
These studies have set the stage for using biosynthetic approaches to expand chemical diversity of fusidane-type antibiotics.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (138 words)

Fusidane-type antibiotics represented by helvolic acid, fusidic acid and cephalosporin P1 are a class of bacteriostatic agents, which have drawn renewed attention because they have no cross-resistance to commonly used antibiotics. However, their biosynthesis is poorly understood. Here, we perform a stepwise introduction of the nine genes from the proposed gene cluster for helvolic acid into Aspergillus oryzae NSAR1, which enables us to isolate helvolic acid (~20 mg L-1) and its 21 derivatives. Anti-Staphylococcus aureus assay reveals that the antibacterial activity of three intermediates is even stronger than that of helvolic acid. Notably, we observe an unusual C-4 demethylation process mediated by a promiscuous short-chain dehydrogenase/reductase (HelC) and a cytochrome P450 enzyme (HelB1), which is distinct from the common sterol biosynthesis. These studies have set the stage for using biosynthetic approaches to expand chemical diversity of fusidane-type antibiotics.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 29158519 · DOI · PMC5696383

Transport of lipophilic carboxylates is mediated by transmembrane helix 2 in multidrug transporter AcrB [2]

Research article Oswald C, Tam HK, Pos KM · · 2016 · cited 63 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
The deployment of multidrug efflux pumps is a powerful defence mechanism for Gram-negative bacterial cells when exposed to antimicrobial agents.
Closing excerpt
We propose that these bound drugs are actively displaced by an upward movement of TM2 towards the AcrB periplasmic porter domain in response to protonation events in the transmembrane domain.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (147 words)

The deployment of multidrug efflux pumps is a powerful defence mechanism for Gram-negative bacterial cells when exposed to antimicrobial agents. The major multidrug efflux transport system in Escherichia coli, AcrAB-TolC, is a tripartite system using the proton-motive force as an energy source. The polyspecific substrate-binding module AcrB uses various pathways to sequester drugs from the periplasm and outer leaflet of the inner membrane. Here we report the asymmetric AcrB structure in complex with fusidic acid at a resolution of 2.5 Å and mutational analysis of the putative fusidic acid binding site at the transmembrane domain. A groove shaped by the interface between transmembrane helix 1 (TM1) and TM2 specifically binds fusidic acid and other lipophilic carboxylated drugs. We propose that these bound drugs are actively displaced by an upward movement of TM2 towards the AcrB periplasmic porter domain in response to protonation events in the transmembrane domain.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 27982032 · DOI · PMC5171871

The global prevalence of fusidic acid resistance in clinical isolates of Staphylococcus aureus: a systematic review and meta-analysis [3]

Meta-analysis Hajikhani B, Goudarzi M, Kakavandi S, Amini S, Zamani S, van Belkum A, et al. · · 2021 · cited 42 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Background and aimStaphylococcus aureus (S.
Closing excerpt
These results indicate the need for prudent prescription of fusidic acid to stop or diminish the incidence of fusidic acid resistance as well as the development of strategies for monitoring the efficacy of fusidic acid use.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (202 words)

Background and aimStaphylococcus aureus (S. aureus) is one of the most common pathogens causing nosocomial and community-acquired infections with high morbidity and mortality rates. Fusidic acid has been increasingly used for the treatment of infections due to methicillin-susceptible S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA). The present study aimed to determine the precise prevalence of fusidic acid resistant MRSA (FRMRSA), fusidic acid resistant MSSA (FRMSSA), and total fusidic acid resistant S. aureus (FRSA) on a global scale.MethodsSeveral international databases including Medline, Embase, and the Web of Sciences were searched (2000-2020) to discern studies addressing the prevalence of FRSA, FRMRSA, and FRMSSA. STATA (version14) software was used to interpret the data.ResultsOf the 1446 records identified from the databases, 215 studies fulfilled the eligibility criteria for the detection of FRSA (208 studies), FRMRSA (143 studies), and FRMSSA (71 studies). The analyses manifested that the global prevalence of FRSA, FRMRSA, and FRMSSA was 0.5%, 2.6% and 6.7%, respectively.ConclusionThis meta-analysis describes an increasing incidence of FRSA, FRMSSA, and FRMRSA. These results indicate the need for prudent prescription of fusidic acid to stop or diminish the incidence of fusidic acid resistance as well as the development of strategies for monitoring the efficacy of fusidic acid use.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 33933162 · DOI · PMC8088720

Bacteriophage and Fusidic Acid Have Synergistic Effect Against Meticillin-Resistant Staphylococcus pseudintermedius in Ex Vivo Canine Dermis Model [4]

Research article Ehling S, Peh E, Oltmanns H, Meissner J, Kittler S, Puff C, et al. · · 2026 · cited 1 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
BackgroundAntimicrobial stewardship has become vital given the progressive emergence of multidrug-resistant bacteria, and novel approaches to the treatment of bacterial infections are needed.
Closing excerpt
Conclusions and clinical relevanceIn conclusion, topical co-treatment with fusidic acid and a phage could be a promising approach to the treatment of canine MRSP pyoderma.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (220 words)

BackgroundAntimicrobial stewardship has become vital given the progressive emergence of multidrug-resistant bacteria, and novel approaches to the treatment of bacterial infections are needed. Recently, reported synergistic effects of antibacterial drugs and bacteriophage therapy have revealed promising applications for the management of meticillin-resistant staphylococcal infections.ObjectivesThe objective of this study was to investigate the response of meticillin-resistant Staphylococcus pseudintermedius (MRSP) to treatment with a newly isolated, lytic MRSP-specific bacteriophage. Furthermore, a postulated synergism between phage and fusidic acid was examined in a canine ex vivo dermis model.Material and methodsSkin was harvested from the lateral thorax of a euthanised dog, clipped, the subcutis removed, and epidermis cleaved via a modified salt-split technique. The ex vivo dermis model established in Franz diffusion cells was inoculated with 1 × 107 colony-forming units (cfu) of a clinical MRSP strain for 16 h. Then, experimental groups were treated with phage vB_SpsS_LmqsKl44-4 at a concentration of 2 × 106 plaque-forming units and fusidic acid 0.4 mg alone or in combination for an additional 8 h.ResultsHistopathological results showed that colonies of MRSP reached the superficial dermis and entered hair follicles. Co-treatment with fusidic acid and phage significantly reduced the amount of MRSP after 8 h.Conclusions and clinical relevanceIn conclusion, topical co-treatment with fusidic acid and a phage could be a promising approach to the treatment of canine MRSP pyoderma.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40968468 · DOI · PMC12967880

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Dumb and dumber--the potential waste of a useful antistaphylococcal agent: emerging fusidic acid resistance in Staphylococcus aureus [5]
    Howden BP, Grayson ML · Clin Infect Dis · 2006 · cited 130 times (Europe PMC)
  • Research article Fusidic Acid: A Bacterial Elongation Factor Inhibitor for the Oral Treatment of Acute and Chronic Staphylococcal Infections [6]
    Fernandes P · Cold Spring Harb Perspect Med · 2016 · cited 108 times (Europe PMC)
  • Research article The antimicrobial activity of fusidic acid [7]
    Verbist L · J Antimicrob Chemother · 1990 · cited 79 times (Europe PMC)
  • Research article Fusidic acid pharmacology, pharmacokinetics and pharmacodynamics [8]
    Turnidge J · Int J Antimicrob Agents · 1999 · cited 76 times (Europe PMC)
  • Research article Fusidic acid in vitro activity [9]
    Collignon P, Turnidge J · Int J Antimicrob Agents · 1999 · cited 67 times (Europe PMC)
  • Research article Fusidic acid resistance in Staphylococcus aureus [10]
    Dobie D, Gray J · Arch Dis Child · 2004 · cited 63 times (Europe PMC)

References

  1. Lv JM, Hu D, Gao H, Kushiro T, Awakawa T, Chen GD, et al.. Biosynthesis of helvolic acid and identification of an unusual C-4-demethylation process distinct from sterol biosynthesis. . 2017. PMID 29158519 · DOI · PMC5696383
  2. Oswald C, Tam HK, Pos KM. Transport of lipophilic carboxylates is mediated by transmembrane helix 2 in multidrug transporter AcrB. . 2016. PMID 27982032 · DOI · PMC5171871
  3. Hajikhani B, Goudarzi M, Kakavandi S, Amini S, Zamani S, van Belkum A, et al.. The global prevalence of fusidic acid resistance in clinical isolates of Staphylococcus aureus: a systematic review and meta-analysis. . 2021. PMID 33933162 · DOI · PMC8088720
  4. Ehling S, Peh E, Oltmanns H, Meissner J, Kittler S, Puff C, et al.. Bacteriophage and Fusidic Acid Have Synergistic Effect Against Meticillin-Resistant Staphylococcus pseudintermedius in Ex Vivo Canine Dermis Model. . 2026. PMID 40968468 · DOI · PMC12967880
  5. Howden BP, Grayson ML. Dumb and dumber--the potential waste of a useful antistaphylococcal agent: emerging fusidic acid resistance in Staphylococcus aureus. Clin Infect Dis. 2006. PMID 16392088 · DOI
  6. Fernandes P. Fusidic Acid: A Bacterial Elongation Factor Inhibitor for the Oral Treatment of Acute and Chronic Staphylococcal Infections. Cold Spring Harb Perspect Med. 2016. PMID 26729758 · DOI · PMC4691801
  7. Verbist L. The antimicrobial activity of fusidic acid. J Antimicrob Chemother. 1990. PMID 2179201 · DOI
  8. Turnidge J. Fusidic acid pharmacology, pharmacokinetics and pharmacodynamics. Int J Antimicrob Agents. 1999. PMID 10528784 · DOI
  9. Collignon P, Turnidge J. Fusidic acid in vitro activity. Int J Antimicrob Agents. 1999. PMID 10528786 · DOI
  10. Dobie D, Gray J. Fusidic acid resistance in Staphylococcus aureus. Arch Dis Child. 2004. PMID 14709515 · DOI · PMC1755935

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-10-31.

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At a glance

1,743
PubMed records on this heading
7%
published since 2020
100
review articles
78
randomized trials
10
verified references below

Counts come from PubMed on 2026-10-31; they show how much has been written, not how strong the evidence is.

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