Silver Sulfadiazine + Chlorhexidine Topical

Indications

Silver Sulfadiazine + Chlorhexidine Topical is used for: Skin disinfection; As antiseptic and disinfectant, Burns

Adult Dose

Topical/Cutaneous Skin disinfection; As antiseptic and disinfectant, Burns Adult: As cream or solution: Apply to skin or to the affected area once or twice daily.

Child Dose

Renal Dose

Administration

Contra Indications

Hypersensitivity to sulphonamides; porphyria; premature infants and infants <2 mth; pregnancy and lactation.

Precautions

Impaired hepatic or renal function; G6PD deficiency; maintain adequate fluid intake. Monitor blood counts. Systemic absorption, resulting in argyria may occur if it is applied to large wound areas and over prolonged periods.

Pregnancy-Lactation

Interactions

Potentiates antidiabetic effect of sulphonylureas. Not antagonised by PABA.

Adverse Effects

Side effects of Silver Sulfadiazine + Chlorhexidine Topical : Nausea, vomiting, diarrhoea; hypersensitivity, skin reactions; haematuria; crystalluria; thrombocytopenia, leucopenia, eosinophilia. Potentially Fatal: Stevens-Johnson syndrome; agranulocytosis, jaundice, hepatitis.

Mechanism of Action

Silver sulfadiazine has broad antimicrobial activity; it is active against gram-positive and gram-negative bacteria as well as some yeasts and fungi. The silver salt acts mainly on the cell wall and membrane to disrupt its intergrity thus allowing it to impair the essential enzymes, bacterial DNA and RNA leading to cell death. Chlorhexidine is a very potent cationic chemoprophylactic agent that has a broad-spectrum of activity against gm+ve and gm-ve bacteria. It is both bacteriostatic and bactericidal depending on its concentration. The bactericidal effect, which is achieved at high concentrations, is due to the binding of the cationic to negatively charged bacterial cell walls and extramicrobial complexes. Bacteriostatic effect is achieved at low concentrations which causes an alteration of bacterial cell osmotic equilibrium and leakage of potassium and phosphorus.