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Use of Dermatologics during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Clioquinol is an antibacterial and antifungal agent. No studies are published on the use of this drug during human or experimental animal pregnancy. Mafenide (Sulfamylon) and silver sulfadiazine (Silvadene, Thermazene, Flint SSD, Sildimac) are topical antibacterial and antifungal agents used to treat infections secondary to skin burns. No human studies of these drugs in human pregnancy and birth defects are published. No animal teratology studies of mafenide are published. According to manufacturer information, silver sulfadiazine was not teratogenic in animal studies (unpublished).
Burns
Published in Dorian Hobday, Ted Welman, Maxim D. Horwitz, Gurjinderpal Singh Pahal, Plastic Surgery for Trauma, 2022
Dorian Hobday, Ted Welman, Maxim D. Horwitz, Gurjinderpal Singh Pahal
Flamazine – Antibiotic (broad spectrum) silver sulfadiazine cream. Breaks down eschar. Apply thinly. Lasts 24 hours. Caution: Do not use in pregnant and neonates, do not use for >14 days.
Sulfadiazine Silver
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Sulfadiazine silver is a sulfonamide-based topical agent which is bactericidal for many gram-negative and gram-positive bacteria as well as being effective against yeast. Silver sulfadiazine may act through a combination of the activity of silver and sulfadiazine. Sulfadiazine silver is indicated as an adjunct for the prevention and treatment of wound infection and sepsis in patients with second- and third-degree burns (1). Side effects of silver sulfadiazine have been reviewed in 2009 (4).
Prevention and treatment of burn wound infections: the role of topical antimicrobials
Published in Expert Review of Anti-infective Therapy, 2022
Deepak K. Ozhathil, Steven E. Wolf
The 1960s was the era of delayed surgical intervention and burn care and saw the introduction of effective antimicrobial topical therapies and tangential surgical excision. In this era, the benefits of moist wound healing was first clearly recognised [13]. Silver sulfadiazine, perhaps the best-known topical antimicrobial therapy, was introduced as Silvadene® by the Marion Corporation in 1968 [14]. At the time, silver sulfadiazine was applied to full-thickness burns (third-degree) for weeks, awaiting spontaneous eschar separation. With poor eschar penetration, silver sulfadiazine functioned as a superficial antimicrobial agent. This turned out to be beneficial, however, because the process of spontaneous eschar separation was actually dependent on bacterial digestion of the eschar at the viable margin. Bacterial proteases breakdown coagulated cellular debris underneath the eschar, while the underlying viable tissue generates granulation to protect itself. In time, the eschar separates from the granulation tissue layer below [15]. For its historical contributions, silver sulfadiazine is considered the gold standard in topical antimicrobial therapies, and nearly all subsequent therapies have been compared to it.
Fractional CO2 laser is as effective as pulsed dye laser for the treatment of hypertrophic scars
Published in Journal of Dermatological Treatment, 2021
Mohammad Radmanesh, Samira Mehramiri, Ramin Radmanesh
After applying topical anesthesia (lidocaine–prilocaine 2.5%) cream under occlusion and cleansing the lesions, the scars were divided into two equal parts. One part was treated with PDL and the other part with FCO2L. The PDL used was Nlite (Chromogenex lasers UK, Swansea, UK) with 585 nm wavelength. The parameters used for PDL were 9 J/cm2 with 5 mm spot size. The FCO2L used was ECO2 Lutronic (Goyang-si, South Korea). The parameters used for FCO2L were: power = 30 W, density = 200 spots/cm2, and pulse energy = 50 mJ for the first two passes and 30 mJ for the 3rd pass. The FCO2L side was treated for three passes to debulk the scar tissues. The coagulated tissue was wiped out before the next pass and no wiping out for the last pass. The PDL side was treated with two superimposed passes. The procedures repeated every month for 4 months. After laser therapy, silver sulfadiazine was applied on both areas and then was covered with sterile gauze. The patients were asked to continue applying silver sulfadiazine cream for few more days and avoid picking up the crust before spontaneous shedding.
Metal Nanoparticles in Infection and Immunity
Published in Immunological Investigations, 2020
As stated above, a large portion of the articles on metal nanoparticles reported on direct antimicrobial activity of the metal particles. This being the case, one wonders if emergence of resistance to metal nanoparticles could occur. In general, emergence of resistance to metals among bacteria appears to be less common than to other, conventional antibiotics. But resistance can emerge, as reported many years ago by McHugh et al. (Mchugh et al. 1975). They reported on an outbreak in their hospital burn unit due to a Salmonella strain resistant to silver as well as other antibiotics. Topical silver in the form of silver sulfadiazine (Silvadene™) is common in burn care due to its broad spectrum of antimicrobial activity. Resistance to zinc has been observed among strains of methicillin-resistant Staph aureus (MRSA) in swine (Hau et al. 2017). With regard to metal nanoparticles, Elbehiry et al. tested if resistance to silver or gold could emerge after prolonged exposure to increasing concentrations of nanoparticles (Elbehiry et al. 2019). They found that resistance emerged more readily to the 20 nm nanoparticles than for the 10 nm particles of both metals. For silver nanoparticles (AgNP), 10 of 20 Staphylococcal strains showed development of resistance to 20 nm particles, while for gold particles (AuNP), only 3 of 20 strains showed emergence of resistance. These findings are not reassuring for the durability of the antibacterial effects of metal nanoparticles, if such nanoparticles should come into widespread use. Resistance to metals is rarely tested for, so it is likely that resistance to metals will be missed unless it is deliberately investigated.