New UK Data Raises Concerns on Fusidic Acid Resistance in Pediatric Patients
KEY TAKEAWAYS
Methicillin-resistant S. aureus (MRSA) prevalence is high across community and hospital S. aureus isolates in the UK.
Pediatric patients demonstrated greater fusidic acid resistance than adults (21% vs 14%).
Study authors urged dermatology-led antimicrobial stewardship to address resistance trends.
A recent UK study showed a shift in antimicrobial resistance patterns in Staphylococcus aureus (S. aureus) isolates associated with atopic dermatitis (AD), which the authors said raised concerns about the use of topical fusidic acid.
Publishing in Cureus, the research team conducted a retrospective analysis that included more than 32,000 S. aureus isolates collected from community and hospital settings in the Black Country region.
According to the data, the overall prevalence of methicillin-resistant S. aureus (MRSA) was 7% in community settings and 11% in hospital-based isolates. Pediatric isolates showed a 10% MRSA prevalence, which were comparable to adult rates (P = 0.47). Fusidic acid resistance was higher in pediatric isolates (21%) vs adults (14%) (P = 0.002). Adults demonstrated higher resistance to erythromycin, clindamycin, and tetracycline.
The findings highlight evolving resistance trends and call into question the frequent use of fusidic acid in dermatology, especially in pediatric populations.
"This study highlights changing staphylococcal epidemiology with concerningly high MRSA and fusidic acid resistance in dermatological isolates," the authors wrote. "Given the frequent use of topical fusidic acid in AD, its role in management should be reconsidered. The findings underscore the need for dermatology-led antimicrobial stewardship to mitigate escalating community resistance in S. aureus infections."
Source: Mian B, et al. Cureus. 2025. Doi:10.7759/cureus.97141