Silvadene (Silver Sulfadiazine) - Topical

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What Is Silvadene?

Silvadene (silver sulfadiazine) is a topical antimicrobial cream used to prevent and treat skin infections after severe burns by applying directly to the skin.

As an antibiotic, silver sulfadiazine works by killing the bacteria or preventing its growth. It is only available by a prescription from your healthcare provider.

Drug Facts

  • Generic Name: Silver sulfadiazine
  • Brand Name(s): Silvadene, SSD, SSD AF, Thermazene
  • Administration Route(s): Topical
  • Drug Availability: Prescription
  • Therapeutic Classification: Antibacterial
  • Available Generically: Yes
  • Controlled Substance: N/A
  • Active Ingredient: Silver sulfadiazine
  • Dosage Form(s): Cream

What Is Silvadene Used For?

The Food and Drug Administration (FDA) approved silver sulfadiazine cream to prevent and treat wound infections in second- and third-degree burns. It is used in addition to other therapies.

People with severe burns or burns that cover a large part of the body may require treatment in a hospital.

How to Use Silvadene

After the burn wounds are cleansed and debrided, apply the cream in a 1/16th inch layer to the affected area once or twice daily. Continue using the cream until wound healing or until the burn site is ready for skin grafting. Reapply cream to any areas where it gets rubbed off by friction or movement. You may cover the treated area with a gauze dressing, but this is not necessary.

Storage

Silver sulfadiazine comes packaged in jars or tubes containing the cream. Store your supply at room temperature (between 68 F and 72 F).

Off-Label Uses

Silver sulfadiazine cream has also been prescribed off-label to treat and prevent infections for other non-burn skin wounds. Although not indicated by the FDA for this use, the cream’s antimicrobial properties make it effective against other infections.

How Long Does Silvadene Take to Work?

Silver sulfadiazine provides soothing upon application to the burn site. The amount of time needed for healing depends on the severity of the wound.

What Are the Side Effects of Silvadene?

This is not a complete list of side effects and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

Silver sulfadiazine may cause mild side effects after applying it to the skin. In some cases, more severe side effects can occur. Tell your healthcare provider about any side effects experienced while using the medication.

Common Side Effects

The most common side effects of silver sulfadiazine are reactions at the site of application, including:

  • Burning 
  • Itching
  • Rash

Severe Side Effects

Contact your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include the following:

Long-Term Side Effects

Continued use of Silvadene can result in skin discoloration and may delay wound healing.

Report Side Effects

Silvadene may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting Program or by phone (1-800-332-1088).

Dosage: How Much Silvadene Should I Use?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For topical dosage form (cream): 

For burn wound infections: 

  • Adults—Apply to the affected areas one or two times a day.
  • Children older than 2 months of age—Use and dose must be determined by the doctor.
  • Premature infants and infants 2 months of age and younger—Use is not recommended.


Modifications

In some cases, your healthcare provider may adjust your treatment or dose.

Pregnancy and Breastfeeding

Avoid using Silvadene in late pregnancy. Like other sulfonamides, silver sulfadiazine can cause kernicterus (brain damage caused by excessive levels of a chemical compound called bilirubin) in newborn infants. There are currently no adequate studies on using silver sulfadiazine during pregnancy.

Whether silver sulfadiazine passes into human breast milk is unknown. However, sulfonamides do pass into breast milk, and all sulfonamides can increase the risk of kernicterus in infants. Because of this, people who are breastfeeding should not use silver sulfadiazine while nursing.

Age

Although not approved for use in children, silver sulfadiazine is commonly prescribed off-label for burns in infants as young as 2 months. Avoid use in infants younger than 2 months due to the risk of kernicterus.

For adults aged 65 and older, silver sulfadiazine shows no difference in safety or efficacy compared to younger individuals.

Missed Dose

If you miss an application of Silvadene, apply it as soon as you remember.

Overdose: What Happens If I Use Too Much Silvadene?

Silver sulfadiazine cream is for external use only. Do not ingest this medication. Keep out of reach from children or pets to prevent accidental ingestion.

What Happens If I Overdose on Silvadene?

If you think you or someone else may have overdosed on Silvadene call a healthcare provider or the Poison Control Center (1-800-222-1222).

If someone collapses or isn't breathing after taking Medrol, call 911 immediately.

Precautions

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It is important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to check for any problems or unwanted effects that may be caused by this medicine. 

If your skin infection or burn does not improve within a few days or weeks (for more serious burns or burns over larger areas), or if it becomes worse, check with your doctor. 

Do not use this medicine for a skin problem that has not been checked by your doctor. 

Check with your doctor right away if you have the following symptoms while using this medicine: bleeding gums, cough or hoarseness, fever with or without chills, painful or difficult urination, sores, ulcers, or white spots on the lips or in the mouth, unusual bleeding, bruising, or weakness, or yellow skin or eyes. These could be symptoms of a blood disorder. 

Check with your doctor right away if you have blistering, peeling, or loose skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are using this medicine. 

Before you have any medical tests, tell the medical doctor in charge that you are using this medicine. The results of some tests may be affected by this medicine. 

This medicine may rarely stain skin brownish gray.

What Are Reasons I Shouldn’t Use Silvadene?

Do not use Silvadene if you have a known hypersensitivity (allergy) to silver sulfadiazine, sulfonamides, or any of its inactive ingredients.

Silver sulfadiazine is a sulfonamide. Sulfonamide drugs have been associated with an increased risk of kernicterus in newborn infants. Therefore, do not use this medication during late pregnancy. Premature infants and newborn infants less than 2 months old should also not use Silvadene.

What Other Medications Interact With Silvadene?

There is no information about using silver sulfadiazine cream and other medications. Do not mix Silvadene cream with other topical products for application at the same site.

What Medications Are Similar?

Similar medications that may also treat burns through topical application include: 

Mafenide

An antimicrobial cream and topical solution, mafenide also treats second- and third-degree burns. It’s similarly effective compared to silver sulfadiazine. However, it can cause severe pain and burning upon application.

Bacitracin

Bacitracin or combinations of bacitracin/neomycin/polymyxin B treat burns in people with allergies to sulfonamides. It can be used on delicate areas such as the face, nose, ears, and perineum.

Mupirocin

Mupirocin, another alternative to sulfonamides, is a topical antibiotic with activity against methicillin-resistant Staphylococcus aureus (MRSA).

Frequently Asked Questions

  • What is Silvadene used for?

    Silver sulfadiazine helps treat severe (second- and third-degree) burns in conjunction with specialized wound care by a healthcare provider trained to manage burns. After cleaning and preparing the burn wound, apply the cream to prevent and treat wound infections and promote healing.

  • How does Silvadene work?

    Silver sulfadiazine has broad antimicrobial coverage, killing Gram-positive and Gram-negative bacteria, as well as some yeast. It can kill organisms by acting on the cell wall and cell membrane of organisms.

  • What are the side effects of Silvadene?

    This antimicrobial cream is generally well tolerated. A small number of people using it may experience skin allergic reactions or blood abnormalities, usually short term.

How Can I Stay Healthy While Using Silvadene?

Work closely with your healthcare provider to determine the best management of burn wounds. 

Wound management usually involves frequent dressing changes and cleaning and removal of dead tissue before starting treatment with Silvadene. Check with your healthcare provider about the progress of wound healing or when it is appropriate to begin skin grafting

If using Silvadene for a non-burn skin infection, continue using it until instructed to stop. Contact your healthcare provider if you notice signs or symptoms of worsening infection.

Symptoms of worsening infection include:

  • Increased pain
  • Redness
  • Change in discharge/exudate (fluid that leaks from infected areas)

Medical Disclaimer

Verywell Health's drug information is meant for education purposes only and not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult your doctor before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

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  1. Food and Drug Administration. Silvadene prescribing information. Updated September 2012.