Silver sulfadiazine

solid

Silver(I) sulfadiazine (AgSD) is popularly used for treating second-degree burn wounds as it acts as an antimicrobial agent and prevents infections. Silver sulfadiazine-impregnated polyurethane (PU) foam, chitosan/chondroitin sulfate films may be used for wound dressing.

Silver sulfadiazine (Silvadene, SSD) is a synthetic agent that combines the beneficial properties of silver nitrate and sulfonamides. It acts upon the cell membrane and cell wall. It is used primarily as an adjunct in the prevention and treatment of wound sepsis in patients with second- and third-degree burns and for wound care of chronic ulcers. It is bactericidal against many gram-positive and gram-negative bacteria as well as C. albicans and is reasonably effective against P. aeruginosa and S. aureus.
Bacteria susceptible to sulfadiazine but resistant to silver nitrate, as well as those sensitive to silver nitrate but resistant to sulfadiazine, have shown good response to silver sulfadiazine. It does not stain, is unlikely to produce electrolyte imbalance, and does not cause systemic acidosis. Some patients note a stinging sensation on application, and because this compound can be absorbed, systemic sulfonamide reactions similar to those caused by sulfonamides may occur.

Silver sulfadiazine is extremely insoluble. In addition to the usual activity of sulfonamides it exhibits activity – almost certainly attributable to the silver component – against Ps. aeruginosa and some fungi.
It is variably absorbed after topical application depending on the integrity of the skin. Toxic concentrations may be achieved in patients with extensive burns. It is used topically, mainly for burns, pressure sores and leg ulcers. Central venous catheters impregnated with chlorhexidine and silver sulfadiazine have been developed to reduce bacterial colonization. Other suggested uses include the prevention of infection in skin graft donor sites and cord care in newborn infants.

The silver salt of sulfadiazine applied in a water-misciblecream base has proved to be an effective topical antimicrobialagent, especially against Pseudomonas spp. This is particularlysignificant in burn therapy because pseudomonadsare often responsible for failures in therapy. The salt is onlyslightly soluble and does not penetrate the cell wall butacts on the external cell structure. Studies using radioactivesilver have shown essentially no absorption into body fluids.Sulfadiazine levels in the serum were about 0.5 to2 mg/100 mL.
This preparation is reported to be easier to use thanother standard burn treatments, such as application offreshly prepared dilute silver nitrate solutions or mafenideointment.