Fucidin H
Fucidin H cream combines 2% Fusidic Acid with 1% Hydrocortisone acetate. It is applied twice daily to eczema that is infected or likely to become infected. The leaflet gives a usual course of up to 2 weeks and says to stop and see the doctor if there is no improvement after 7 days (Fucidin H PIL 2026). That is longer than the 5–7 days NICE NG190 allows for fusidic acid. NG190 does not list steroid–antibiotic combination products at all, and says a well child with infected eczema should not routinely get an antibiotic.
Fucidin H [part-of] Fusidic Acid Hydrocortisone [part-of] Fucidin H Fucidin H [treats] Infected Eczema
Conflict: [NICE NG190, 2021-03] limits topical fusidic acid to 5–7 days, for localised infection only. [Fucidin H PIL, LEO Pharma, rev. 2026-05] gives a “usual treatment time” of “up to 2 weeks”. Already logged in infection-treatment-conflicts.md (see Fusidic Acid).
Evidence. A Cochrane review (George et al., 2019) found steroid–antibiotic combinations may give slightly more short-term improvement than steroid alone (RR 1.10, low-quality evidence). There was probably no difference in quality of life. The hydrocortisone does the main work on the eczema, and the antibiotic adds little.
Toddler safety and resistance. Hydrocortisone 1% is a mild steroid, suited to a toddler’s face and body (Topical Corticosteroids). Still, the leaflet warns that steroid side effects are more likely in babies and children, and that a nappy can act as an occlusive dressing. It contains butylhydroxyanisole and cetyl alcohol, which can cause contact rashes, and it must be kept away from the eyes. The bigger risk is resistance. Harkins et al. (BJD 2018) found fusidic acid resistance about 2.5 times more frequent in staph from children with Atopic Dermatitis. They noted fusidic acid is “widely used topically … and in AD with topical corticosteroids”. A tube of Fucidin H kept at home “for flares” is exactly the repeated exposure NICE warns against. Plain mild steroid plus Emollient Therapy is the default, and the combination cream is kept for a GP-confirmed localised infection (Antimicrobial Resistance).
Fucidin H [causes] Antimicrobial Resistance Fucidin H [relates] Topical Corticosteroids
Connections
- Fusidic Acid — combination product, source: Fucidin H PIL
- Infected Eczema — licensed use, source: Fucidin H PIL
- Hydrocortisone — mild steroid component, source: Fucidin H PIL
- NICE NG190 — no combination products listed; 5–7 day fusidic limit, source: NICE 2021
- Cochrane — combination slightly better than steroid alone (low quality), source: George 2019
- Antimicrobial Resistance — combination use linked to fusidic resistance, source: Harkins BJD 2018
- Topical Corticosteroids — steroid side-effect warnings in children, source: Fucidin H PIL