Study on the Antibacterial Activity of Fusidic Acid and Rifampicin Against MRSA from Wound Samples

Abstract

MRSA wound infections are common globally, with variations in prevalence (community vs hospital) and regional resistance patterns. Fusidic acid and rifampicin are active against MRSA, but their comparative efficacy in superficial wounds is not fully characterized. To review the epidemiology of MRSA in wounds, co-pathogens, MRSA virulence, and laboratory detection methods; and to compare fusidic acid and rifampicin susceptibility, resistance mechanisms, synergy, and clinical outcomes in MRSA wound infections. We conducted a literature search (PubMed, Scopus, Web of Science, 2004–2024) for studies on MRSA in skin/wound infections, focusing on FA and RIF activity. Selection criteria prioritized original research, clinical trials, and official guidelines. Data on MRSA prevalence, co-isolates, FA/RIF MICs, susceptibility rates, synergy studies, and clinical trials were extracted and synthesized. Key studies were tabulated, and PRISMA flow and timeline diagrams (mermaid) prepared. MRSA prevalence in wound infections varies widely (0–50% by region) and is higher in healthcare settings. Common co-pathogens include Pseudomonas aeruginosa and Enterobacteriaceae. MRSA virulence factors include mecA (PBP2a), Panton-Valentine leukocidin, and biofilm formation. Culture with cefoxitin screening and PCR for mecA are gold-standard diagnostics. Susceptibility data show most MRSA are sensitive to FA and RIF (FA resistance ~2–6% globally; RIF resistance ~3–5% in selected surveys). Synergy studies demonstrate that FA+RIF kill MRSA more effectively than monotherapy. Clinically, combination FA+RIF regimens have eradicated MRSA carriage in special populations, but high-quality trials in wound infections are lacking. FA and RIF remain valuable for MRSA wound infections, especially in combination. We recommend culture-guided therapy: use FA topically/systemically when MRSA is FA-susceptible; add RIF (with another agent) for deeper or persistent infections. Avoid RIF monotherapy. Strict infection control and stewardship are essential to prevent resistance.