Indications
Mafenide is an antibacterial cream used on second and third degree burns to prevent and treat infection of the burn wound. It is also used, in solution form, as a wet dressing over skin grafts. Treatment is usually started and supervised in a hospital or burns unit.
How It Works
Mafenide is a sulfonamide-type antibacterial that stops bacteria from making substances they need to grow. It penetrates thick burned skin (eschar) well and is active against many bacteria found in burns, including Pseudomonas.
Dosage and Administration
Applied by a doctor, nurse or trained carer with sterile gloves. After the burn is cleaned, the cream is spread in a thin layer (about 1 to 2 mm) over the burned area once or twice a day, so the wound stays covered at all times; more is added to areas where it has rubbed off. Dressings are optional. Treatment usually continues until the wound is healing well or ready for grafting, as directed by the burns team.
Interactions
Mafenide can add to the acid-forming effect of other medicines that act on the enzyme carbonic anhydrase, such as Acetazolamide. Tell the care team about all medicines, especially for breathing, kidney or blood problems.
Contraindications
- Allergy to Mafenide.
- Use with caution, or avoid, in people with a known allergy to sulfonamide (sulfa) medicines.
Side Effects
Pain or a burning sensation on application is common and may last a short time. Other effects include itching, rash, redness, swelling and delayed separation of burned skin. Because it is absorbed, it can cause metabolic acidosis (too much acid in the blood), which may show as fast, deep breathing.
Tell the doctor or nurse at once about rapid or difficult breathing, unusual tiredness or confusion, a widespread rash, blistering or swelling of the face, dark urine or yellow skin (possible red blood cell breakdown), or signs of worsening infection such as fever or a bad smell from the wound.
Pregnancy and Lactation
Use in pregnancy only if the doctor judges the benefit outweighs the risk, and it is generally avoided near the end of pregnancy. Sulfonamides can pass into breast milk and may affect a newborn; the doctor will advise on breastfeeding.
Precautions and Warnings
Blood acid and electrolyte levels may be checked, especially when large areas are treated or in people with kidney or lung problems. Use with care in people with G6PD deficiency, as it may cause breakdown of red blood cells. For external use only; keep away from the eyes.
Overdose
Use over very large areas can lead to severe acidosis. The care team may stop the cream for a day or two and treat the acid balance. If cream is swallowed, seek medical advice.
Therapeutic Class
Topical antibacterial (sulfonamide) for burns.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Avoid excessive heat.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.