Fusidic Acid (Fucithalmic) Eye Drops in Infants Under 2 Years
Fusidic acid 1% viscous eye drops (Fucithalmic) is safe and effective for treating bacterial conjunctivitis in babies under 2 years of age, including neonates, with twice-daily dosing providing excellent compliance and clinical outcomes.
Evidence for Safety and Efficacy in Young Infants
The evidence strongly supports the use of fusidic acid eye drops in very young children:
A large randomized controlled trial specifically evaluated 456 neonates (gestational age >32 weeks) with acute bacterial conjunctivitis in the first 28 days of life, demonstrating 89% cure rates with fusidic acid 1% applied twice daily, with no safety concerns reported 1
Compliance was significantly superior with fusidic acid compared to chloramphenicol (90.7% vs 78.0%, p<0.001) in neonates, primarily due to the convenient twice-daily dosing regimen 1
In children aged 2-9 years with bacterial conjunctivitis, fusidic acid showed significantly better compliance (85% vs 47%, p<0.001) and was rated as more convenient (97% vs 54%, p<0.001) compared to tobramycin 2
Pharmacokinetic Advantages
Fusidic acid viscous eye drops have unique sustained-release properties that make them particularly suitable for pediatric use:
The carbomer vehicle provides prolonged antibiotic concentrations in tear fluid with an excretion half-life of 1.9 hours, allowing effective twice-daily dosing 3
Adequate intraocular penetration is achieved, with aqueous humor levels of 0.3-0.8 mcg/ml maintained for at least 12 hours after dosing 4
Clinical Efficacy
Clinical and bacteriologic efficacy of fusidic acid is equivalent to other broad-spectrum antibiotics like tobramycin, with 65.9% of suspected bacterial conjunctivitis cases showing positive bacterial cultures 2
The presence of mucopurulent discharge directly correlates with bacterial pathogens, making fusidic acid an appropriate first-line choice for suspected bacterial conjunctivitis 2
Dosing Recommendation
For infants under 2 years with suspected bacterial conjunctivitis: Apply one drop of fusidic acid 1% to the affected eye(s) twice daily for 7 days 2, 1
Important Caveats
The neonatal study specifically included infants with gestational age >32 weeks, so use caution in extremely premature infants 1
While the evidence documents safety in neonates and young children, always monitor for any adverse reactions, though none were reported in the clinical trials 2, 1
The twice-daily dosing significantly improves compliance compared to more frequent dosing regimens required by other antibiotics, which is particularly important in young children 1