Get your patient on Silver Sulfadiazine - Silver Sulfadiazine cream (Silver Sulfadiazine)

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Silver Sulfadiazine - Silver Sulfadiazine cream prescribing information

Indications & Usage

INDICATIONS AND USAGE

Silver sulfadiazine cream, USP 1% is a topical antimicrobial drug indicated as an adjunct for the prevention and treatment of wound sepsis in patients with second and third degree burns.

Dosage & Administration

DOSAGE AND ADMINISTRATION

Prompt institution of appropriate regimens for care of the burned patient is of prime importance and includes the control of shock and pain. The burn wounds are then cleansed and debrided; silver sulfadiazine cream, USP 1% is then applied under sterile conditions. The burn areas should be covered with silver sulfadiazine cream, USP 1% at all times. The cream should be applied once to twice daily to a thickness of approximately one sixteenth of an inch. Whenever necessary, the cream should be reapplied to any areas from which it has been removed by patient activity. Administration may be accomplished in minimal time because dressings are not required. However, if individual patient requirements make dressings necessary, they may be used.
Reapply immediately after hydrotherapy. Treatment with silver sulfadiazine cream, USP 1% should be continued until satisfactory healing has occurred or until the burn site is ready for grafting. The drug should not be withdrawn from the therapeutic regimen while there remains the possibility of infection except if a significant adverse reaction occurs.

Contraindications

CONTRAINDICATIONS

Silver sulfadiazine cream, USP 1% is contraindicated in patients who are hypersensitive to silver sulfadiazine or any of the other ingredients in the preparation.
Because sulfonamide therapy is known to increase the possibility of kernicterus, silver sulfadiazine cream, USP 1% should not be used on pregnant women approaching or at term, on premature infants, or on newborn infants during the first 2 months of life.

Adverse Reactions

ADVERSE REACTIONS

Several cases of transient leukopenia have been reported in patients receiving silver sulfadiazine therapy. 1,2,3 Leukopenia associated with silver sulfadiazine administration is primarily characterized by decreased neutrophil count.  Maximal white blood cell depression occurs within two to four days of initiation of therapy.  Rebound to normal leukocyte levels follows onset within two to three days.  Recovery is not influenced by continuation of silver sulfadiazine therapy. An increased incidence has been seen in patients treated concurrently with cimetidine.
Other infrequently occurring events include skin necrosis, erythema multiforme, skin discoloration, burning sensation, rashes, and interstitial nephritis.
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.  However, reduction in bacterial colonization has caused delayed separation, in some cases necessitating escharotomy in order to prevent contracture.

Description

DESCRIPTION

Silver sulfadiazine cream, USP 1% is a soft, white, water dispersible cream containing the antimicrobial agent silver sulfadiazine in micronized form for topical application.  Each gram of silver sulfadiazine cream contains 10mg of micronized silver sulfadiazine.
This active agent has the following structural formula:

Referenced Image

Silver sulfadiazine cream contains 1% w/w silver sulfadiazine.  The vehicle in which the active ingredient is dispersed consists of water, stearyl alcohol, white petrolatum, polyoxyl 40 stearate, propylene glycol, isopropyl myristate, and sorbitan monooleate with 0.3% methylparaben as a preservative.

Pharmacology

CLINICAL PHARMACOLOGY

Silver sulfadiazine has broad antimicrobial activity. It is bactericidal for many gram-negative and gram-positive bacteria as well as being effective against yeast. Results from in vitro testing are listed below.
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.
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. Silver sulfadiazine acts only on the cell membrane and cell wall to produce its bactericidal effect.

Results of in Vitro Testing With Silver
Sulfadiazine Cream, USP 1% Concentration of
Silver Sulfadiazine Number of Sensitive Strains /
Total Number of Strains Tested
Pseudomonas aeruginosa Xanthomonas (Pseudomonas) Maltophilia Enterobacter species Enterobacter cloacae Klebsiella species Escherichia coli Serratia species Proteus mirabilis Morganella morganii Providencia rettgeri Proteus vulgaris Providencia species Citrobacter species Acinetobacter calcoaceticus Stahylococcus aureus Staphylococcus epidermidis β-Hemolytic Streptococcus Enterococcus species Corynebacterium diphtheriae Clostridium perfringens Candida albicans
Genus and Species 50 µg/mL 100 µg/mL
130/130 130/130
7/7 7/7
48/50 50/50
24/24 24/24
53/54 54/54
63/63 63/63
27/28 28/28
53/53 53/53
10/10 10/10
2/2 2/2
2/2 2/2
1/1 1/1
10/10 10/10
10/11 11/11
100/101 100/101
51/51 51/51
4/4 4/4
52/53 52/53
2/2 2/2
0/2 2/2
43/50 50/50

Silver sulfadiazine is not a carbonic anhydrase inhibitor and may be useful in situations where such agents are contraindicated.

How Supplied/Storage & Handling

HOW SUPPLIED

Silver sulfadiazine cream, USP 1% - white to off-white cream
NDC Number Size
67877-124-20 20g tube
67877-124-25 25g tube
67877-124-05 50g tube
67877-124-85 85g tube
67877-124-50 50g jar
67877-124-40 400g jar
67877-124-10 1000g jar

Store at room temperature. 15°-30°C (59°-86°F).

Manufactured for:
Ascend Laboratories, LLC
Parsippany, NJ 07054

Manufactured by:
Crown Laboratories, Inc.
Johnson City, TN 37604

Product Information: 1-877-272-7901




Revised: DEC 2018
P1840.05

Data SourceWe receive information directly from the FDA and PrescriberPoint is updated as frequently as changes are made available
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