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
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References in periodicals archive ?
The doctors used about a pound of Silvadene (an antibiotic/anesthetic cream for treating skin infections in patients with severe burns) to cover my hand an inch thick, then bandaged me up.
Silvadene bum cream is great stuff sporting both antimicrobial and anesthetic properties.
Standard care of RadiaPlex gel, Silvadene, and hydrocortisone cream use was allowed.
Postoperative perineal care included conjugated estrogen cream and bacitracin in 34 patients and Silvadene cream in 3 patients, with sitz baths twice daily.
The management plan includes in-hospital wound debridement, parents' doing daffy dressing changes with Silvadene, and pain control.
A cost analysis done in 2005 of Silvadene, an older treatment method, versus a sheet of ionic silver took several factors--including salaries, nursing time, and cost of raw materials--into consideration beyond initial cost.
Topical bacitracin zinc (Bacitracin), a triple ointment of neomycin sulfate, bacitracin zinc, and polymyxin B sulfate (Neosporin), and silver sulfadiazine (Silvadene) were compared with petrolatum as a control in a well-conducted RCT of 426 patients with uncomplicated wounds seen at a military community hospital.
Although we could give her silvadene cream and dressing supplies, there is no access to sunscreen even if it were affordable, nor is there an understanding of why anyone would need it.
"After cleansing, the affected area should be covered with a dressing and a topical antibiotic such as bacitracin, polysporin, or silvadene, which help prevent infection and decrease pain."
A treatment consisting of a dressing with Silvadene was prescribed.
Topical treatments were a part of chronic wound care: "They put a salve on the wound." "They're applying Silvadene and that helped cure the one toe and the other toe is almost cured." At times, treatment affected mobility.