Products
Silver sulfadiazine is commercially available as creams and gauzes (Flammazine, Ialugen Plus with hyaluronic acid to promote wound healing). It has been approved in many countries since 1974.
Structure and properties
Sulfadiazine (C10H10N4O2S, Mr = 250.3 g/mol) exists as in the form of crystals or as a crystalline powder with white, yellowish or light pink color. It is practically insoluble in water.
Effects
Silver sulfadiazine (ATC D06BA01) is antibacterial: sulfadiazine is bacteriostatic, and silver is bactericidal. The effects of sulfadiazine are based on the inhibition of folic acid synthesis in the bacteria.
Indications
Silver sulfadiazine is used for infection prophylaxis and treatment of skin and wound infections, pressure ulcers, leg ulcers, and burns.
Dosage
Necrotic tissue must be removed before use. The cream is applied once daily and covered with a sterile dressing to protect it from sunlight. Exposure to sunlight may cause the skin to turn gray. The gauze is also applied once a day. It must also be covered and fixed with gauze.
Contraindications
Silver sulfadiazine is contraindicated in hypersensitivity to the active substance or sulfonamides. It should not be used during pregnancy and lactation, nor in neonates. Caution should be exercised in renal insufficiency and hepatic parenchymal damage, as sulfadiazine may be nephro- and hepatotoxic. Furthermore, sulfadiazine may cause blood count disturbances such as leukopenia. Patients with glucose-6-phosphate dehydrogenase deficiency should not use the drug.
Interactions
Silver may locally reduce the action of proteolytic enzymes.
Adverse effects
Possible adverse effects include allergic reactions, skin reactions such as a skin burning sensation or pain, gray discoloration of the skin. Leukopenias have been reported, but whether they are related to the drug is controversial. Sulfonamides may cause kernicterus.
