TOPICAL ANTIBACTERIALS AND ANTIFUNGALS
International Brand Name:
Silvadene, Flamazine, Thermazene,
In treatment of:
Adjunctive prevention and treatment of infection in severe burns
4. Systemic toxicity when applied on large surface area
5. Transient leucopenia (comes back to normal in 4 -5 days).
1. Hypersensitivity to Silver sulphadiazine and other Sulphonamide
2. Deep infections
1. Renal impairment
2. Hepatic impairment
3. G6PD deficiency
4. Withdraw the drug immediately if rashes appears
Cyclosporine: Decreased efficacy and increased nephrotoxicity with cotrimoxazole.
Methotrexate: Bone marrow depressant effect potentiated.
Phenytoin: Half-life prolonged.
Sulfonylureas: Increased hypoglycemic effect.
Thiazide diuretics: Increased risk of thrombocytopenic purpura in elderly.
Warfarin: Anticoagulant effect potentiated.
Pyrimethamine: Megaloblastic anaemia.
Oral contraceptives: Failure of oral contraceptives.
Lab test: Interferes with serum methotrexate assay by the competitive binding protein technique (CBPA).
Jaffe alkaline picrate reaction assay for creatinine: Overestimation of 10% of normal values.
Topical proteolytic enzymes: Silver may inactivate such enzymes.
Adult: Silver sulphadiazine 1 % w/ w cream and 1% w/ v solution is used. Apply as a film of about 2 -3 mm thick directly to the burn or on a sterile gauze dressing. If needed reapply after complete removal of previous applications with saline.