SILVADENE
SILVADENE- silver sulfadiazine cream
Pfizer Laboratories Div Pfizer Inc
DESCRIPTION
SILVADENE Cream 1% is a soft, white, water-miscible cream containing the antimicrobial agent silver sulfadiazine in micronized form, which has the following structural formula:
Each gram of SILVADENE Cream 1% contains 10 mg of micronized silver sulfadiazine. The cream vehicle consists of white petrolatum, stearyl alcohol, isopropyl myristate, sorbitan monooleate, polyoxyl 40 stearate, propylene glycol, and water, with methylparaben 0.3% as a preservative. SILVADENE Cream 1% (silver sulfadiazine) spreads easily and can be washed off readily with water.
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.
Genus & Species | 50 μg/mL | 100 μg/mL |
Pseudomonas | ||
aeruginosa | 130/130 | 130/130 |
Xanthomonas (Pseudomonas) | ||
maltophilia | 7/7 | 7/7 |
Enterobacter species | 48/50 | 50/50 |
Enterobacter cloacae | 24/24 | 24/24 |
Klebsiella species | 53/54 | 54/54 |
Escherichia coli | 63/63 | 63/63 |
Serratia species | 27/28 | 28/28 |
Proteus mirabilis | 53/53 | 53/53 |
Morganella morganii | 10/10 | 10/10 |
Providencia rettgeri | 2/2 | 2/2 |
Providencia species | 1/1 | 1/1 |
Proteus vulgaris | 2/2 | 2/2 |
Citrobacter species | 10/10 | 10/10 |
Acinetobacter | ||
calcoaceticus | 10/11 | 11/11 |
Staphylococcus aureus | 100/101 | 100/101 |
Staphylococcus | ||
epidermidis | 51/51 | 51/51 |
β-Hemolytic | ||
Streptococcus | 4/4 | 4/4 |
Enterococcus species | 52/53 | 53/53 |
Corynebacterium- | ||
diphtheriae | 2/2 | 2/2 |
Clostridium perfringens | 0/2 | 2/2 |
Candida albicans | 43/50 | 50/50 |
Silver sulfadiazine is not a carbonic anhydrase inhibitor and may be useful in situations where such agents are contraindicated.
INDICATIONS AND USAGE
SILVADENE Cream 1% (silver sulfadiazine) 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.
CONTRAINDICATIONS
SILVADENE Cream 1% (silver sulfadiazine) 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, SILVADENE Cream 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.
WARNINGS
Absorption of silver sulfadiazine varies depending upon the percent of body surface area and the extent of the tissue damage. Although few have been reported, it is possible that any adverse reaction associated with sulfonamides may occur. Some of the reactions, which have been associated with sulfonamides, are as follows: blood dyscrasias including agranulocytosis, aplastic anemia, thrombocytopenia, leukopenia, and hemolytic anemia; dermatologic and allergic reactions, including life-threatening cutaneous reactions [Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and exfoliative dermatitis]; gastrointestinal reactions; hepatitis and hepatocellular necrosis; CNS reactions; and toxic nephrosis.
There is potential cross-sensitivity between silver sulfadiazine and other sulfonamides. If allergic reactions attributable to treatment with silver sulfadiazine occur, continuation of therapy must be weighed against the potential hazards of the particular allergic reaction.
Fungal proliferation in and below the eschar may occur. However, the incidence of clinically reported fungal superinfection is low.
The use of SILVADENE Cream 1% (silver sulfadiazine) in some cases of glucose-6-phosphate dehydrogenase-deficient individuals may be hazardous, as hemolysis may occur.
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