Silver sulfadiazine

Chemical Properties

solid

Uses

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.

Uses

Coordination compound. Antibacterial

Uses

Indicated as an adjunct for the prevention and treatment of wound sepsis in patients with second- and third-degree burns.

Definition

ChEBI: Silver(1+) sulfadiazinate is a silver salt, a sulfonamidate and a member of pyrimidines. It has a role as an antimicrobial agent and an antibacterial drug. It contains a sulfadiazinate.

Indications

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.

Pharmaceutical Applications

Silver sulfadiazine is indicated for the prophylaxis and treatment of infections in burn wounds. Silver sulfadiazine is highly insoluble in water, and as a result, it does not cause hypochloraemia in burns in contrast to silver nitrate.
The active ingredient silver sulfadiazine is a sulfur-derived topical antibacterial used primarily on secondand third-degree burns. It is known to be active against many Gram-negative and Gram-positive bacteria as well as against yeast. The cream is kept applied to the burned skin at all times for the duration of the healing period or until a graft is applied. It prevents the growth of a wide array of bacteria, as well as yeast, on the damaged skin. Caution has to be given to large-area application as sulfadiazine levels in the plasma may well reach therapeutic levels that can cause side effects.

Pharmaceutical Applications

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.

Clinical Use

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.

Veterinary Drugs and Treatments

Silver sulfadiazine cream is a broad spectrum agent which covers bacteria (gram positive and negative) and fungal agents. It has been used extensively in people suffering from skin burns. It is nontoxic to the skin, conjunctiva and cornea and has been used in the last several years for cases of fungal keratitis. Particularly good results have been noted in cases of superficial keratitis prior to development of advanced disease. Clinical response is better when used early in the course of the disease. Treatment with silver sulfadiazine is considered non-conventional in people. It is gaining in popularity in the treatment of equine fungal keratitis by veterinary ophthalmologists. For medico-legal reasons, in very expensive horses in which litigation may be an issue, treatment with more conventional therapy (natamycin) may be indicated first, or consideration can be given to signed consent regarding treatment with silver sulfadiazine. The initial response to this drug has been promising, however.

Veterinary Drugs and Treatments

Topical silver sulfadiazine (SSD) is used topically for prophylaxis and treatment of 2nd and 3rd degree burns. It is also useful in treating localized pyodermas caused by Pseudomonas spp.
SSD has extensive antimicrobial activity and is bactericidal for yeasts and many gram-negative and gram-positive bacteria. SSD acts via disrupting microbial cell membranes and cell walls; this differs from the antibacterial actions of silver nitrate or sodium sulfadiazine.