Comparative study of fusidic acid versus pristinamycin in skin infections requiring an oral antibiotherapy

OBJECTIVE: This study was aimed to compare the clinical and antibacterial e fficacy of fusidic acid 500 mg twice a day, per os, over 7,5 days) to prist inamycin 1 g twice a day, per os, over 10 days). METHODS: Patients aged over 18, suffering from a superficial pyoderma requi ring antibiotherapy and having given their informed consent were enrolled i n a controlled, multicentre, double blind double dummy, parallel groups stu dy. From day 0 to day 10, the patients received the randomised treatment. T hose who were cured at day 1 1 had a visit at day 25 without any treatment between day 1 1 and day 25. A swab was performed on days 0, 11 and 25. The two treatment groups were compared in terms of efficacy, safety and global cost. RESULTS: 334 patients seen in dermatologic consultation were included in th e study. 313 patients were analysed on an intent-to-treat basis. 158 receiv ed fusidic acid (FA) and 155 were treated with pristinamycin (P). At D11, 1 26 patients were cured in the FA group (79.7%) and 118 in the P group (76.1 %) (p=0.44). The bacteriological success rate was 85.2% in the FA group and 82.7 in the P group (p=0.67). The recovery was confirmed in 92.6% of the F A patients and 90.4% of the P patients at D25 (p=0.56). Digestive tolerance was better with fusidic acid than with pristinamycin. in economic terms, f usidic acid was cheaper than pristinamycin : 443 French francs in the FA gr oup versus 545 FF in the P group. CONCLUSION: Therefore we conclude that an oral course of 7.5 days with fusi dic acid is an efficient and cheaper alternative to a treatment with pristi namycin over 10 days.