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Retapamulin + fusidic acid is a topical combination of two antibacterial agents used for the treatment of skin infections such as impetigo. Retapamulin is a pleuromutilin antibiotic that inhibits bacterial protein synthesis by binding to the 50S subunit of the bacterial ribosome, specifically at domain V of 23S rRNA, thereby blocking peptidyl transfer and P-site interactions essential for protein synthesis[2][5][6]. Fusidic acid is a steroidal antibiotic that acts by inhibiting bacterial protein synthesis through prevention of elongation factor G (EF-G) translocation on the ribosome[4]. Both agents are effective against Gram-positive bacteria, including Staphylococcus aureus and Streptococcus pyogenes. Clinical studies have shown that retapamulin and fusidic acid have comparable efficacy in treating impetigo, even in cases involving resistant strains[3][5][8].
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