Silver Sulphadiazine 1% Topical
Indications
Silver Sulphadiazine 1% Topical is used for:
Cuts, Wounds, Severe burns, Post-operative wound dressing, Bed sores
Adult Dose
Topical/Cutaneous
Treatment and prophylaxis of infection in severe burns
Adult: Apply onto affected area 1-2 times/day.
Child Dose
Burn Wound Infections (2°/3°)
<2 months: Contraindicated
>2 months (1% cream): Apply onto affected area 1-2 times/day.
Renal Dose
Administration
Burns: The burn wound should be cleaned and cream applied over all the affected areas to a depth of 3-5mm. Where necessary, the cream should be re-applied to any area from which it has been removed by patient activity. In burns, cream should be re-applied at least every 24 hours or more frequently if the volume of exudate is large.
Hand burns: Before application of Silver Sulphadiazine cream to the burn, the whole hand should be enclosed in a clear plastic bag or glove . The patient should be encouraged to move the hand and fingers. The dressing should be changed when an excessive amount of exudate has accumulated in the bag.
Leg Ulcers/Pressure Sores: The cavity of the ulcer should be filled with Cream to a depth of at least 3-5mm. As Cream can cause maceration of normal skin on prolonged contact, care should be taken to prevent spread onto non-ulcerated areas. Application of Cream should be followed by an absorbent pad or gauze dressing, with further application of pressure bandaging as appropriate for the ulcer.The dressings should normally be changed daily but for wounds which are less exudative, less frequent changes (every 48 hours) may be acceptable.
Contra Indications
Silver sulfadiazine cream is contraindicated in patients known to be hypersensitivity to silver sulphonamide or to other components of the preparation such as cetyl alcohol or propylene glycol. Because sulphonamide therapy is known to increase the possibility of kernicterus, silver sulphadiazine cream should not be used in pregnant women at term, in premature infants or in infants during the first months of life. It should not be used if hepatic and renal functions become impaired or if the condition of porphyria is suspected.
Precautions
Silver sulfadiazine cream should be used with caution in the presence of significant hepatic or renal impairment or if the condition of porphyria is suspected. Caution of use is required in patients known to be sensitive to systemic sulphonamides and in individuals known to have glucose-6-phosphate dehydrogenase deficiency and concomitant use with topical proteolytic enzymes. Use of silver sulfadiazine cream may delay separation of burn eschar and may alter the appearance of the burn wounds.
Lactation: Not known if distributed into breast milk; use caution
Pregnancy-Lactation
Pregnancy category: C, X (near term)
Lactation: Not known if distributed into breast milk; use caution
Interactions
Potentiates antidiabetic effect of sulphonylureas. Not antagonised by PABA.
Side Effects
Side effects of Silver Sulphadiazine 1% Topical :
The most common sides effects are allergic reactions including burning, itching and rashes; argyria reported following prolonged use. Transient leucopenia may occur in patients receiving silver sulfadiazine therapy.
Mode of Action
Silver sulfadiazine has broad antimicrobial activity; it is active against gram-positive and gram-negative bacteria as well as some yeasts and fungi. The silver salt acts mainly on the cell wall and membrane to disrupt its intergrity thus allowing it to impair the essential enzymes, bacterial DNA and RNA leading to cell death.