silver sulfADIAZINE

(sil-ver sul-fa-dye-a-zeen) ,


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Therapeutic: anti infectives
Pharmacologic: sulfonamides
Pregnancy Category: B


Prevention and treatment of wound sepsis in patients with 2nd- and 3rd-degree burns.Management of:
  • Minor skin infections,
  • Dermal ulcers.


Splits to produce bactericidal concentrations of silver and sulfadiazine.
Action is at level of cell membrane and cell wall.

Therapeutic effects

Bactericidal action against organisms found in burns.
Broad spectrum includes activity against many gram-negative and gram-positive bacteria, anaerobes, and some yeast.


Absorption: Small amounts of silver are systemically absorbed following topical application. Up to 10% of sulfadiazine is absorbed.
Distribution: Unknown.
Metabolism and Excretion: Absorbed sulfadiazine is excreted unchanged by the kidneys.
Half-life: Unknown.

Time/action profile (anti-infective action)

Topicalon contactunknownas long as applied


Contraindicated in: Hypersensitivity (cross-sensitivity with sulfonamides may occur); Pediatric: Infants <2 mo (↑ risk of kernicterus); Obstetric: Pregnancy near term (↑ risk of kernicterus in infant); G6PD deficiency; Porphyria.
Use Cautiously in: Impaired hepatic or renal function.

Adverse Reactions/Side Effects


  • exfoliative dermatitis (life-threatening)
  • stevens-johnson syndrome (life-threatening)
  • toxic epidermal necrolysis (life-threatening)
  • burning
  • itching
  • pain
  • rash
  • skin discoloration
  • skin necrosis


  • leukopenia


Drug-Drug interaction

Silver may inactivate concurrently applied topical proteolytic enzymes (fibrinolysin, desoxyribonuclease).


Topical (Adults and Children >1 mo) Apply 1% cream 1–2 times daily in layer 1.5-mm thick.

Availability (generic available)

Cream: 1%

Nursing implications

Nursing assessment

  • Assess burned tissue for infection (purulent discharge, excessive moisture, odor, and culture results) and sepsis (WBC, fever, or shock) prior to and throughout course of therapy.
  • Monitor for hypersensitivity reaction (rash, itching, or burning) at and surrounding sites of application.
  • Assess patient for skin rash frequently during therapy. Discontinue silver sulfadiazine at first sign of rash; may be life-threatening. Stevens-Johnson syndrome or toxic epidermal necrolysis may develop. Treat symptomatically; may recur once treatment is stopped.
  • Lab Test Considerations: Monitor renal function studies and CBC periodically when applied to large area; systemic absorption may cause nephritis and reversible leukopenia. Decrease in neutrophil count is greatest 4 days after initiation of therapy; levels usually normalize after 2–3 days.

Potential Nursing Diagnoses

Risk for infection (Indications)
Risk for impaired skin integrity (Indications)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)


  • Generally applied after cleansing and debriding of burn wound. Premedicate with analgesic.
  • Topical: Cream is white; discard if it becomes dark.
    • Use sterile technique to apply. Cover entire wound at depth of 1.5 mm. Reapply to sites where cream rubs off as a result of patient movement; burn should be coated at all times. Burn may be dressed or kept open, depending on recommendation of health care professional.

Patient/Family Teaching

  • Explain purpose of medication to patient and family. This medication will not stain skin.
  • Advise patient to promptly notify health care provider if rash occurs.

Evaluation/Desired Outcomes

  • Prevention and treatment of infection in 2nd- and 3rd-degree burns. Therapy is continued until burn is healed or skin graft is performed.
Drug Guide, © 2015 Farlex and Partners


Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005
References in periodicals archive ?
Medicines for flu, allergy, heat and blood pressure such as Arinac, Panadol CF, Actifed P, Adalat, Tronolane, Azomax, Zatofem, Flamazine, are not available, said Tahir Ali, a salesman at the medical store in Aabpara.
The management entailed primary closure in 99 (64.2%) patients, while conservative management with topical silver sulphadiazide (Flamazine, Smith and Nephew SA, SA) applied in 45 (29.2%) patients.
2 days Often delayed injury to Often delayed treatment Topical Flamazine, Betadine, Jelonet, acriflavin therapy acriflavin, Burnshield, Jelonet Pain control Occasional Occasional Initial Only major burns Dealt with many of the management referred small burns Referral No evidence that the Similar provincial protocol was implemented on a general basis.
[11] Initial daily application of silver sulfadiazine (Flamazine) or Acticoat (Smith & Nephew, Hull, UK) was done and subsequent topical therapy was dictated by bacteriological profiles of the wounds.
The drugs included midazolam, a powerful sedative; Lidocaine, an anaesthetic; and flamazine, which is used for treating burn wounds.
A 1% silver sulfadiazine cream (Flamazine, Smith and Nephew, Saint Laurent, Quebec, Canada) was applied topically to the wounds, followed by an amorphous hydrogel (Curafil, Tyco Healthcare/ Kendall, Mansfield, MA, USA), and the feet were bandaged with a semipermeable, transparent, adhesive bandage (Tegaderm, 3M Animal Care Products, St Paul, MN, USA).
Flamazine, the silver sulphadiazine burns cream, was used to treat burns patients at the time.
aeruginosa (even if clinically suspected and not yet proven with a positive swab) with daily soaks with an unbuffered sodium hypochlorite solution, [13] after which the wounds were dressed with Flamazine dressings.
Sodium hypochlorite soaks followed by Flamazine dressings accounted for the vast majority of the dressings, with chlorhexidine being used when an organism resistant to Flamazine was isolated.
aeruginosa resistant to Flamazine was cultured from 6 patients.
The drugs included the powerful sedative midazolam, the anaesthetic Lidocaine and Flamazine, which is used for treating burn wounds.
Side effects include blood pressure drop FLAMAZINE Cream used for treatment of infection in burn wounds.