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.