Silver Sulfadiazine (Silvadene)
- Discussion: (see silvadene.com)
- silvadene burn cream is a 1% suspension of silver sulfadiazine in a water soluble base;
- for prevention and treatment of wound sepsis in patients with second and third degree burns;
- topical bactercidal agent effective against many gran negative and positive bacteria as well as yeast, however, is absorbed poorly through the eschar site, and is ineffective against enterobacter and pseudomonas;
- silver sulfadiazine is painless on application (and is often soothing) and causes no acid base abnormalities;
- silver sulfadiazine is poorly soluble and has only limited ability to penetrate into the burn wound;
- thus, it is relatively ineffective in controlling bacterial proliferation in the eschar once high bacterial densities have occurred;
- nearly all enterobacter and pseudomonas will develop resistance;
- note: resistance to silvadene is mediated by plasmids which may also confer resistance to other antibiotics;
- dosage: apply qd to bid to burn area (dressings not required over burn area)
- use w/ caution in patients with G6P defficiency (increased risk of hemolysis);
- ? aspirin is a good screening drug for G6P deficiency;
- accumulation of the drug may occur in patients with impaired renal or hepatic function;
- note possible depression myeloid elements in blood and resistance exhibited by certain gram negative bacteria;
- granulocytopenia typically occurs within the first 5 days after injury
- the myeloid depression is typically reversable expect when a profound thrombocytopenia accompanies the neutropenia
Comparison of silver sulfadiazine, povidone-iodine and physiologic saline in the treatment of chronic pressure ulcers.
In vivo and in vitro antimicrobial activity of silver sulfadiazine and cerium nitrate.
A Randomized Prospective Study of Topical Antimicrobial Agents on Skin Grafts After Thermal Injury.
Comparison of silver sulphadiazine 1 per cent, silver sulphadiazine 1 % plus chlorhexidine digluconate 0.2 per cent and mafenide acetate 8.5 per cent for topical antibacterial effect in infected full skin thickness rat burn wounds.
Comparison of silver sulfadiazine 1% with chlorhexidine digluconate 0.2% to silver sulfadiazine 1% alone in the prophylactic topical antibacterial treatment of burns.
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Data Trace Staff on Thursday, December 6, 2012 4:26 pm