title: High levels of fusidic acid-resistant Staphylococcus aureus in dermatology patients.
abstract: BACKGROUND
  Antibiotic resistance is a significant problem both in hospitals and the community. Topical antibiotics are widely used for dermatological problems and this may be leading to the emergence of resistant bacteria.
  
  
  OBJECTIVE
  To assess the level of fusidic acid-resistant Staphylococcus aureus inpatients with dermatological problems.
  
  
  METHODS
  All microbiology samples over a 4-month period were tested for antibiotic sensitivities. Patients with cultures positive for S. aureus were studied.
  
  
  RESULTS
  The study shows 50% of S. aureus isolates from dermatology patients were resistant to fusidic acid. This figure rose to 78% inpatients with atopic eczema. Of patients with fusidic acid-resistant S. aureus isolates, 96% had used a fusidic acid-containing preparation within the previous 6 months. The level of fusidic acid resistance in S. aureus samples cultured from nondermatology patients was only 9.6%, a level significantly below that for dermatology patients (P < 0.001).
  
  
  CONCLUSIONS
  High levels of fusidic acid-resistant S. aureus are found in dermatology patients. Inappropriate use of topical antibiotics in dermatology patients leading to fusidic acid resistance may threaten the efficacy of systemic fusidic acid for the treatment of serious S. aureus infections. Education of health professionals and restriction of the use of fusidic acid is needed.
authors.affiliation: Department of Dermatology, Dewsbury & District Hospital, Dewsbury, West Yorkshire, WF13 4HS, UK. Manu.Shah@midyorks.nhs.uk
authors.forename: M
authors.initials: M
authors.lastname: Shah
authors.forename: M
authors.initials: M
authors.lastname: Mohanraj
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents; D002648:Child; D002675:Child, Preschool; D003880:Dermatology; D024881:Drug Resistance, Bacterial; D005260:Female; D005672:Fusidic Acid; D006748:Hospital Departments; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012871:Skin Diseases / Q000188:drug therapy / Q000382:microbiology; D013211:Staphylococcus aureus / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D005672:Fusidic Acid