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Sulfamylon: Mafenide Acetate

- Discussion:
    - often this agent is used on recipient autograft sites or on partial-thickness burn wounds;
    - its bacteriostatic properties against both gram-positive and gram- negative organisms (especially pseudomonas aeruginosa) and some anaerobes make it an especially useful agent;
    - this agent has the broadest spectrum of activity against pseudomonas organisms in particular and gram negative organisms in general;
           - in vitro resistance to pseudomonas has never been demonstrated;
    - it is the best agent for treating patients in whom a dense bacterial proliferation in the wound;
    - it has limited activity against staphlococcus;
    - its application may be painful in partial thickness burns;

- Sulfamylon (mafenide acetate):
    - is used either as an 8.5% cream or mixed with saline to form a slurry;
    - 11.1% suspension of mafenide acetate, which is bacterostatic, is freely soluble, and readily diffuses through the eschar to establish an effective concentration at the nonviable viable tissue interface;

- Precautions:
    - as a side effect, metabolic acidosis may develop;
    - atopy occurs in approximately 7% of patients treated with mafenide acetate however, this is usually controled with antihistamines

Five percent mafenide acetate solution in the treatment of thermal injuries.

Cytotoxicity to human leukocytes by topical antimicrobial agents used for burn care.

Differential inhibition of human basal keratinocyte growth to silver sulfadiazine and mafenide acetate.

Comparison of silver sulphadiazine 1 per cent, silver sulphadiazine 1 per cent 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.

Survival benefit conferred by topical antimicrobial preparations in burn patients: a historical perspective.