Silver sulfadiazine is used as an adjunct in the prevention and treatment of infection in second- and third-degree burns after resuscitative measures (including control of shock and pain, and correction of electrolyte imbalance) have been instituted. Because infection may extend tissue destruction beyond the burned area and may destroy epithelial islands that could initiate healing, control of bacterial growth may prevent the conversion of deep, partial-thickness wounds to full thickness. Concomitant administration of appropriate systemic anti-infective agents may be necessary if infection is present or suspected.
Although silver sulfadiazine appears to be as effective as silver nitrate or mafenide, controlled studies comparing the effectiveness of silver sulfadiazine and other standard antibacterial burn treatments have not been published. Mafenide appears to penetrate the burn eschar better than does silver sulfadiazine and, therefore, may be more effective in minimizing the growth of bacteria. However, because of the softening action of silver sulfadiazine cream, removal of the eschar and preparation of the wound for grafting is apparently easier than after treatment with mafenide preparations. Unlike mafenide, silver sulfadiazine is not a carbonic anhydrase inhibitor and, therefore, does not alter acid-base balance. Unlike silver nitrate solutions, silver sulfadiazine cream does not alter electrolyte balance and does not stain tissues or dressings.