Silver sulfadiazine

FDA label

Read the full label on DailyMed ↗

Renal Undefined

Hepatic Undefined

Instructions

• Control shock and pain first; cleanse and debride burn wound before applying.
• Apply under sterile conditions to a thickness of about one sixteenth of an inch; burn areas must stay covered with cream at all times.
• Reapply to any area from which cream has been removed by patient activity; reapply immediately after hydrotherapy.
• Dressings not required; may be used if individual patient needs require them.
• Continue until satisfactory healing or until burn site is ready for grafting; do not withdraw while possibility of infection remains, except for a significant adverse reaction.

Contraindications

• Pregnant women approaching or at term — sulfonamides increase risk of kernicterus.
• Premature infants, and newborns during the first 2 months of life — kernicterus risk.

Cautions

• Transient leukopenia (chiefly decreased neutrophils); WBC nadir 2–4 days after start, rebound within 2–3 days; recovery not affected by continuing therapy.
• Higher incidence of leukopenia with concurrent cimetidine.
• Sulfonamide class — kernicterus risk at term, in premature infants, and in infants <2 months.
• Reduced bacterial colonization can delay eschar separation, occasionally requiring escharotomy to prevent contracture.
• Safety and effectiveness in children not established.

Adverse reactions

• Transient leukopenia (decreased neutrophil count)
• Skin necrosis
• Erythema multiforme
• Skin discoloration
• Burning sensation, rashes
• Interstitial nephritis
• Delayed eschar separation

Pregnancy Category B; no adequate human studies — use only if clearly justified, especially approaching or at term (contraindicated at/near term).

Lactation Excretion in human milk unknown; sulfonamides are excreted in milk and can cause kernicterus — decide whether to stop nursing or the drug.