Silver sulfadiazine

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Silver sulfadiazine
Clinical data
Trade namesSilvadene
Other names(4-Amino-N-2-pyrimidinylbenzenesulfonamidato-NN,01)-silver, sulfadiazine silver, silver (I) sulfadiazine, 4-amino-N-(2-pyrimidinyl)benzenesulfonamide silver salt
AHFS/Drugs.comMonograph
MedlinePlusa682598
Pregnancy
category
  • B (not recommended in late pregnancy)
Topical
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability<1% (silver), 10% (sulfadiazine)
Protein bindingHigh (silver)
Excretion2/3 kidney (sulfadiazine)
Identifiers
  • Silver [(4-aminophenyl)sulfonyl](pyrimidin-2-yl)azanide
JSmol)
Melting point285 °C (545 °F)
  • [Ag+].O=S(=O)([N-]c1ncccn1)c2ccc(N)cc2
  • InChI=1S/C10H9N4O2S.Ag/c11-8-2-4-9(5-3-8)17(15,16)14-10-12-6-1-7-13-10;/h1-7H,11H2;/q-1;+1 checkY
  • Key:UEJSSZHHYBHCEL-UHFFFAOYSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Silver sulfadiazine, sold under the brand Silvadene among others, is a

topical antibiotic used in partial thickness and full thickness burns to prevent infection.[1] Tentative evidence has found other antibiotics to be more effective, and therefore it is no longer generally recommended for second-degree (partial-thickness) burns, but is still widely used to protect third-degree (full-thickness) burns.[2][3]

Common side effects include itching and pain at the site of use.

pregnant women who are close to delivery.[4] It is not recommended for use in children less than two months of age.[4]

Silver sulfadiazine was discovered in the 1960s.

generic medication.[4]

Medical uses

Tentative evidence has found other antibiotics to be more effective in the healing of superficial and partial thickness burn injuries; therefore, it is no longer generally recommended.

sloughing of the wound surface that makes reassessment of wound depth difficult, and requires daily reapplication.[9] For this reason, application of silver sulfadiazine is not recommended for most burns due to altered wound appearance and the frequency of required dressing changes.[9]

Adverse effects

A noninfection-related clear fluid may form on the wound's surface. Burning and painful sensations are not uncommon, but are only temporary.[citation needed]

Application to large areas or to severe burns may lead to systemic absorption and lead to

antidiabetics
; but data on the likelihood of cross-allergies are inconsistent.

Incorporation of the silver ions can lead to local argyria (discoloration of the skin), especially if the treated area is exposed to ultraviolet light. Generalised argyria with silver accumulation in kidneys, liver, and retina has only been found in association with excessive long-term use, or repeated use on severe and heavily inflamed burns. Possible consequences of generalised argyria include interstitial nephritis and anemia.[11]

Interactions

clostridiopeptidase, which are contained in ointments used for the removal of dead skin on wounds, can be inhibited by silver ions if applied simultaneously. When silver sulfadiazine is absorbed in significant amounts, it can increase effects and side effects of some drugs such as vitamin K antagonists.[11]

Pharmacokinetics

The chemical is poorly soluble, and has only very limited penetration through intact skin.[11][12] However, contact with body fluids produces free sulfadiazine which can then be systemically absorbed and distributed; it undergoes glucuronidation in the liver and is also excreted unaltered in urine.[12] Only when applied to large-area (especially second- and third-degree) burns or other lesions is absorption into the body a problem.[11][12]

Society and culture

Brand names

Brand names include Silvadene (a

genericized trademark), Silverex, Silverol, Silveleb, Silvazine, Flamazine, Thermazene, BurnHeal, Ebermine, Silvozin Tulle Dressing and SSD.[13]

References

  1. ISBN 978-1455749874. Archived
    from the original on 13 September 2016.
  2. ^
    PMID 23543513
    . It is impossible to draw firm and confident conclusions about the effectiveness of specific dressings, however silver sulphadiazine was consistently associated with poorer healing outcomes than biosynthetic, silicon-coated and silver dressings whilst hydrogel-treated burns had better healing outcomes than those treated with usual care.
  3. ^
    PMID 27126813
    .
  4. ^ a b c d e f "Silver Sulfadiazine". Drugs.com. American Society of Health-System Pharmacists. 1 June 2008. Archived from the original on 20 September 2016. Retrieved 30 August 2016.
  5. ISBN 978-0323091619. Archived
    from the original on 13 September 2016.
  6. hdl:10665/325771
    . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  7. PMID 20238345
    .
  8. PMID 18705778
    .
  9. ^ a b Maitz P, Harish B (15 April 2016). "How to Treat: Burns". Australian Doctor. Retrieved 15 November 2017.
  10. ^ "Silver Sulfadiazine". Drugs.com. 2017. Retrieved 16 November 2017.
  11. ^
    ISBN 978-3-85200-181-4
    .
  12. ^ a b c "Silver sulfadiazine - Drug Summary". Prescribers' Digital Reference. 2017. Retrieved 16 November 2017.
  13. ^ "SSD Uses, Side Effects & Warnings". Drugs.com. Archived from the original on 17 April 2011. Retrieved 3 July 2011. This source names Silvadene, SSD, SSD AF, Thermazene
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