Indications
Silver Sulfadiazine 1% cream is used on the skin to prevent and treat infection in second and third degree burns. It may also be used on some leg ulcers, skin graft donor sites and other wounds at risk of infection, as advised by a doctor.
How It Works
The cream combines silver with sulfadiazine, a sulfonamide antibiotic. Silver is slowly released into the wound, where it damages the cell walls and membranes of bacteria and some yeasts. This gives broad protection against many germs that commonly infect burns, including Pseudomonas and Staphylococcus.
Dosage and Administration
Clean the burn or wound as advised, then, using a sterile glove or spatula, apply a layer about 3 to 5 mm thick once or twice daily, or as directed by the doctor or nurse. Keep the area covered with the cream at all times; reapply where it has rubbed off. A dressing may be used. Continue until the wound has healed or is ready for grafting. Large burns are treated in hospital.
Interactions
Enzyme-based wound cleaning products may be inactivated by the silver. When applied to large areas, enough sulfadiazine may be absorbed to increase the effects of Warfarin, Phenytoin and some oral diabetes medicines such as Glibenclamide. Avoid using other creams on the same area unless advised.
Contraindications
Do not use if allergic to silver sulfadiazine or other sulfonamide (sulfa) medicines, in premature babies or newborns under 2 months (risk of kernicterus, a type of brain damage from jaundice), or in late pregnancy near term.
Side Effects
Common effects include burning, itching or pain where applied and skin rash. Grey or bluish discoloration of the skin can occur with long use over large areas. When large areas are treated, low white blood cell counts, kidney problems and serious skin reactions can rarely occur.
Get urgent medical help if you develop fever, sore throat, mouth ulcers, unusual bruising, yellowing of the skin or eyes, dark urine, a widespread rash with blistering or peeling, or swelling of the face or difficulty breathing.
Pregnancy and Lactation
Use in pregnancy only if clearly needed, and avoid in late pregnancy near delivery because sulfonamides can cause jaundice in the newborn. Small amounts may pass into breast milk; avoid in breastfeeding of premature or jaundiced babies, and ask a doctor before use while breastfeeding.
Precautions and Warnings
For external use only; avoid the eyes and mouth. Use with care in people with G6PD deficiency, kidney or liver disease, or when treating large areas, as blood counts and kidney function may need checking. Seek medical care for any burn that is large, deep, on the face, hands, feet or genitals, or in a young child or older adult.
Overdose
Overdose from skin use is unlikely unless very large areas are treated for a long time, which may cause sulfonamide side effects. If swallowed, seek medical advice.
Therapeutic Class
Topical antibacterial (silver sulfonamide for burns)
Storage
Store below 30°C in a dry place, away from light and out of the reach of children. Do not use if the cream has darkened significantly.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.