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Silvadene Cream For Sunburn
For severe sunburn, especially with blistering, have patients apply 1% silver sulfadiazine (Silvadene Cream) b.I.D. (including after showering). Patients report less pain and faster healing. Of course, check for medication allergies before prescribing this treatment. — Elaine Lund, NP, MSN, Norwich, N.Y.
Application of silver sulfadiazine has been used for topical psoralen-induced partial-thickness sunburns that involved 6%-40% of total body-surface area in three children. The burns resulted from unsupervised sun exposure and all healed without infection or contracture (Burns. 2000;26:653-655). Silvadene Cream combines the beneficial properties and potential adverse systemic reactions of silver nitrate and sulfonamides. Since this topical compound can be systemically absorbed, it should not be used in patients who are allergic to sulfonamides (sulfa drugs), nor should it be used in infants younger than 2 months. Other medical conditions (e.G., blood problems, kidney disease, liver disease, and glucose-6-phosphate dehydrogenase deficiency) may also influence the decision to use Silvadene Cream. — Philip R. Cohen, MD (102-21)
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From the April 13, 2007 Issue of Clinical Advisor
Silver Sulfadiazine Topical - Uses, Side Effects, And More
Who should not use silver sulfadiazine?Allergies to Ingredients. People who are allergic to any of the following should not use topical silver sulfadiazine.
Your pharmacist can tell you all of the ingredients in the specific topical silver sulfadiazine products they stock.
Term or Near Term Pregnancy. Do not use topical silver sulfadiazine if you are pregnant and at or near your delivery date. See the Pregnancy section below for more details.
Premature Babies or Newborns Younger than 2 Months Old. Premature babies or newborn infants during the first 2 months of life should not use topical silver sulfadiazine because of a possible serious side effect called kernicterus. Kernicterus is a condition when a substance called bilirubin builds up in your blood and causes brain damage.
What should I know about silver sulfadiazine before using it?Do not use topical silver sulfadiazine unless it has been prescribed to you by a healthcare provider. Use it as prescribed.
Do not share topical silver sulfadiazine with other people, even if they have the same condition as you. It may harm them.
Keep topical silver sulfadiazine out of the reach of children.
Topical silver sulfadiazine is only for use on the skin. Do not get topical silver sulfadiazine in your eyes.
You should continue to use silver sulfadiazine until the area is healed or until the site is ready for grafting.
What should I tell my healthcare provider before using silver sulfadiazine?Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if topical silver sulfadiazine is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following health conditions.
Pregnancy. It is not known if or how topical silver sulfadiazine could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should use topical silver sulfadiazine while you are pregnant or trying to get pregnant. Severe side effects can occur in a baby if the mother uses topical silver sulfadiazine near her delivery date.
Breastfeeding. It is not known if topical silver sulfadiazine passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Severe side effects can occur in a baby who is fed by a mother who is using topical silver sulfadiazine. Talk with your healthcare provider about stopping either breastfeeding or topical silver sulfadiazine.
Clearing Up Pressure Sores
I have noticed increased popularity in the use of silver sulfadiazine cream (Silvadene) for a variety of wounds, including pressure sores and similar wounds, but not third-degree burns. The results are usually dramatic. Should Silvadene cream be the first choice for such wounds? Is there supportive literature?—FERNANDO HERNANDEZ, MD, Chicago
Is the use of phenytoin powder (Dilantin tablets crushed and applied b.I.D.) acceptable for poorly healing decubitus or pressure ulcers? I have used it successfully on several patients.—BERND RAPHAEL, MD, Lehigh Acres, Fla.
Silver sulfadiazine is certainly a frequent choice for wounds and burns. A survey of the literature indicates that some other topical antibiotics may be equally or more effective, including iodophors and Neosporin (bacitracin, neomycin, polymixin B). Therefore, silver sulfadiazine is certainly an option, but not the obligatory first-line agent. Topical phenytoin has been used successfully in the healing of pressure sores, venous stasis and diabetic ulcers, traumatic wounds, and burns. Oral phenytoin therapy is used widely for the treatment of convulsive disorders. About half the patients treated develop gingival overgrowth as a side effect. This apparent stimulatory effect prompted its assessment in wound healing.—Jeffrey M. Weinberg, MD (147-10)
From the January 01, 2011 Issue of Clinical Advisor
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