This is an automatically translated article.
Sulfadiazine silver is indicated for use in the treatment and prevention of bacterial infections caused by burns. In addition, the drug also kills bacteria by inhibiting the formation of cell membranes and bacterial cell walls. However, the drug also causes some side effects such as itching, pain, skin color changes... Therefore, before using Sulfadiazine silver, it is necessary to consult the treating doctor to use the drug effectively. .
1. Mechanism of action of the drug Sulfadiazine silver
Sulfadiazine silver belongs to the group of antibacterial drugs synthesized from the reaction of silver nitrate with sulfadiazine used topically to help prevent and treat infections of second-degree and third-degree burns. Mechanism of action of nitrates and sulfadiazines. Sulfadiazine silver acts on bacterial cell membranes and coats. Unlike sulfadiazine or other sulphonamides, the effect of Sulfadiazine silver is not dependent on inhibition of folic acid synthesis by bacteria and is not competitively inhibited by aminobenzoic acid. Both Sulfadiazine silver and sodium silver bind to DNA in vitro, but unlike silver nitrate, the binding of Sulfadiazine silver to DNA is not sufficient to account for its in vivo activity. Sulfadiazine silver is used topically, and has a broad spectrum of activity against most strains of gram-positive and gram-negative bacteria. Therefore, Sulfadiazine silver has bactericidal properties, but sometimes resistant bacteria are still present.
In Vitro, Sulfadiazine silver at concentrations from 10 to 50 micrograms/ml can inhibit most bacterial strains such as Klebsiella, Proteus, Pseudomonas and Staphylococcus. Sulfadiazine silver also inhibits Escherichia coli, Corynebacterium diphtheria and certain strains of Acinetobacter, Citrobacter, Enterobacter, Providencia, Serratia and Streptococcus. Candida albicans can also be inhibited at concentrations of 50-100 micrograms/ml and Herpesvirus can also be inhibited at concentrations of 10 micrograms/ml. At higher concentrations, Sulfadiazine silver can inhibit Clostridium botulinum bacteria. And Sulfadiazine silver cream also has the effect of softening the plaque, making it easier to remove the plaque and prepare for skin grafting. Sulfadiazine silver is not a carbonic anhydrase inhibitor and therefore will not upset the acid-base balance. Sulfadiazine silver cream does not alter the electrolyte balance and does not stain clothes.
Sulfadiazine silver is not absorbed by itself. When the drug comes into contact with body tissues and fluids, Sulfadiazine silver reacts slowly with sodium chloride, sulfhydryl groups and proteins to release sulfadiazine and these compounds can be absorbed into the body at the site of application. Especially when applying the drug to 2nd degree burns. When using Sulfadiazine silver over a large area, the serum concentration of sulfadiazine can reach 12 mg/dl. Using Sulfadiazine silver cream 1% at a dose of 5 to 10g/day, the blood concentration of sulfadiazine is 1 to 2mg/dl. Concentrations of 100 to 200 mg of sulfadiazine are excreted in the urine within 24 hours of application of the cream. In the case of applying about 5 to 15 grams/kg/day with 1% Sulfadiazine silver cream on small abrasions for about 100 days, unidentified silver compounds were deposited in body tissues and no lesions were seen. renal function at that time.
2. Indications and contraindications to using Sulfadiazine silver
Sulfadiazine silver is indicated in the prevention and treatment of infections in patients with 2nd degree burns and 3rd degree burns, or after being resuscitated to relieve pain, shock, ablation... Sulfadiazine silver is also used to treat infections. Short-term support, treatment of bacterial infections of leg ulcers and places where the pressure rubs on pieces caused by lying down for a long time or not being active. Or Sulfadiazine silver can be used to help prevent local infections in people with skin grafts or extensive skin abrasions. In addition, Sulfadiazine silver is also indicated for the conservative treatment of fingertip lesions such as nail loss.
However, Sulfadiazine silver is also contraindicated in cases where sulfonamides can cause jaundice or should not be used for women nearing their due date, or premature babies or infants under 2 months. People who are sensitive to the Sulfadiazine silver component of the drug or other ingredients should also not use the drug. In case it is necessary to use drugs for treatment, it is necessary to consult a specialist doctor.
3. Dosage and how to use Sulfadiazine silver
Sulfadiazine silver is used in adults in the following way: cleaning and removing necrotic tissue from the wound. Next, using sterile gloves, apply a layer of cream about 1 to 3 mm thick to the burned area with a frequency of 1 to 2 times a day. However, when applying Sulfadiazine silver, care should be taken to apply it to the crevices, or to the cracks or blisters on the burn. Usually, after applying the medicine, there is no need to cover the wound, but if the dusty environment can be a factor for wound infection, it is advisable to use gauze to wrap the wound after applying the medicine. Daily washing of the wound with sterile water and removal of necrotic tissue should be performed, especially for 3rd degree burns. The patient continued to be treated with Sulfadiazine silver until the wound healed or when the peels could be grafted.
For children, although safety and effectiveness have not been clearly established in pediatric patients, Sulfadiazine silver is used in some cases of pediatric burns. However, because sulfonamide therapy can cause neonatal jaundice, Sulfadiazine silver is contraindicated in preterm neonates and infants under 2 months of age.
For other subjects with underlying diseases such as liver failure, renal failure, accumulation of sulfadiazine may occur. Therefore, the use of Sulfadiazine silver should be considered for the treatment of these patients.
4. Undesirable side effects of the drug Sulfadiazine silver
Using Sulfadiazine silver may experience some unwanted side effects such as:
Itching, pain, burning, local rash, eczema, contact dermatitis, leukopenia... The side effects are few. and rarely include: eosinophilia, leukopenia, pain, megaloblastic anemia, hemolytic anemia, thrombocytopenia, agranulocytosis, pancytopenia, photosensitivity , toxic epidermal necrolysis, Stevens Johnson syndrome... Some notes when using Sulfadiazine silver
Sulfadiazine silver drug can cause liver and kidney damage because sulfadiazine can be accumulated in the body. Therefore, Sulfadiazine silver should be used with caution in subjects with this pathology. Sulfadiazine silver is used for the treatment of extensive burns, but caution and monitoring of serum sulfadiazine levels and renal function are required. For people with deficiency of the enzyme glucose-6 phosphate dehydrogenase, caution should be exercised when using the drug because the active ingredient of the drug can cause hemolytic anemia. Sulfadiazine silver contains propylene glycol, which can affect the results of some tests, so it should be used with caution and avoided before performing tests to check health indicators. There are not enough studies on the side effects of Sulfadiazine silver in pregnant women. Sulfadiazine silver should be used during pregnancy only when carefully weighing the benefits and possible risks to the health of the mother and unborn baby. However, in cases of imminent delivery, Sulfadiazine silver is contraindicated because it can cause neonatal jaundice. For nursing mothers, whether Sulfadiazine silver can pass into breast milk or not, there are no studies to prove it, but sufonamide is distributed in breast milk and may cause nuclear jaundice in infants under 2 months of age. . Therefore, when using drugs for these subjects must be very cautious. Before using the drug, the patient should carefully read the instructions above to use the drug effectively.
Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.
