Treatment with Silver Sulfadiazine Cream should be continued until satisfactory healing has occurred or until the burn site is ready for grafting. However, if individual patient requirements make dressings necessary, they may be used. Administration may be accomplished in minimal time because dressings are not required. Whenever necessary, the cream should be reapplied to any areas from which it has been removed due to patient activity. The cream should be applied once to twice daily to a thickness of approximately 1/16 inch. The burn areas should be covered with Silver Sulfadiazine Cream at all times. The burn wounds are then cleansed and debrided and Silver Sulfadiazine Cream is applied under sterile conditions. Some of the reactions which have been associated with sulfonamides are as follows: blood dyscrasias, including agranulocytosis, aplastic anemia, thrombocytopenia, leucopenia, hemolytic anemia dermatologic and allergic reactions, Stevens-Johnson syndrome and exfoliative dermatitis gastrointestinal reactions hepatitis and hepatocellular necrosis CNS reactions and toxic nephrosis.įOR TOPICAL USE ONLY - NOT FOR OPHTHALMIC USE: Prompt institution of appropriate regimens for care of the burned patient is of prime importance and includes the control of shock and pain. Although few have been reported, it is possible that any adverse reaction associated with sulfonamides may occur. However, reduction in bacterial colonization has caused delayed separation, in some cases necessitating escharotomy in order to prevent contracture.Ībsorption of silver sulfadiazine varies depending upon the percent of body surface area and the extent of the tissue damage. Reduction in bacterial growth after application of topical antibacterial agents has been reported to permit spontaneous healing of deep partial-thickness burns by preventing conversion of the partial thickness to full thickness by sepsis. Other infrequently occurring events include skin necrosis, erythema multiforme, skin discoloration, burning sensation, rashes, and interstitial nephritis. A higher incidence has been seen in patients treated concurrently with cimetidine. The incidence of leucopenia in various reports averages about 20%. Recovery is not influenced by continuation of silver sulfadiazine therapy. Rebound to normal leukocyte levels follows onset within two to three days. Maximal white blood cell depression occurs within two to four days of initiation of therapy. Leucopenia associated with silver sulfadiazine administration is primarily characterized by decreased neutrophil count. Several cases of transient leucopenia have been reported in patients receiving silver sulfadiazine therapy. Silver sulfadiazine is not a carbonic anhydrase inhibitor and may be useful in situations where such agents are contraindicated. Number of Sensitive Strains / Total Number of Strains Tested Genus and Species Results of In Vitro Testing With Silver Sulfadiazine Cream, 1% Concentration of Silver Sulfadiazine Silver sulfadiazine acts only on the cell wall to produce its bactericidal effect. Studies utilizing radioactive micronized silver sulfadiazine, electron microscopy, and biochemical techniques have revealed that the mechanism of action of silver sulfadiazine on bacteria differs from silver nitrate and sodium sulfadiazine. Sufficient data have been obtained to demonstrate that silver sulfadiazine will inhibit bacteria that are resistant to other antimicrobial agents and that the compound is superior to sulfadiazine. Results from in vitro testing are listed below. It is bactericidal for many gram-negative and gram-positive bacteria as well as being effective against yeast. Silver sulfadiazine has broad antimicrobial activity.
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