Mafenide acetate

Topically active sulfonamides are useful in preventing infections in burn patients. Mafenide acetate... 

Sodium sulfacetamide ophthalmic solution or ointment is effective in the treatment of bacterial conjunctivitis and as adjunctive therapy for trachoma. Another sulfonamide, mafenide acetate, is used topically but can be absorbed from burn sites. The drug and its primary metabolite inhibit carbonic anhydrase and can cause metabolic acidosis, a side effect that limits its usefulness. Silver sulfadiazine is a much less toxic topical sulfonamide and is preferred to mafenide for prevention of infection of burn wounds. 

Sulfamylon for 5% topical solution is provided in packets containing 50 g of sterile mafenide acetate to be reconstituted in 1000 mL of sterile water for irrigation or 0.9% sodium chloride irrigation. After mixing, the solution con-... 

Bum wounds— anti-infective Mafenide acetate Sulfamylon... 

Administration Most sulfa drugs are well absorbed after oral administration. Sulfasalazine [sul fa SAL a zeen], when administered orally or as a suppository, is reserved for treatment of chronic inflammatory bowel disease (for example, Crohn s disease or ulcerative colitis), because it is not absorbed. Similarly, succinylsulfathiazole [suks in ill sul fa THI a zole] is used for the treatment of salmonella and shigella carriers. Intravenous sulfonamides are generally reserved for patients who are unable to take oral preparations. Because of the risk of sensitization, sulfas are not usually applied topically. In burn units, creams of mafenide acetate (p-aminomethylbenzensulfonamide) or silver sulfadiazine have been effective in reducing burn sepsis. However, superinfections with resistant bacteria or fungi may occur. 

Correct answer = D. Creams containing mafenide acetate are used in bum units where they are used prophylactically to protect against infection with a variety of gram-negative and... 

Ohlgisser M, Adler M, Ben-Dov D, Taitelman U, Birkhan HJ, Bursztein S. Methaemoglobinaemia induced by mafenide acetate in children. A report of two cases. Br J Anaesth 1978 50(3) 299-301. 

Mafenide is a topical sulfonamide that has been used for the treatment of burns but is now obsolete. Its adverse effects include hyperchloremic metabolic acidosis and (possibly) methemoglobinemia (1). Pulmonary insufficiency has been ascribed to mafenide acetate cream (SEDA-8,160). 

Many substances are contraindicated during the topical use of sutilains. These include detergents and anti-infectives that denature the enzyme preparation. The antibiotics penicillin. streptomycin, and neomycin do not inactivate sutilains. Mafenide acetate is also compatible with the enzyme. 

Treatment of skin lesions also follows decontamination and removal of clothes. Decontamination should be completed within 15 min after exposure to minimize any systemic effects. Contaminated hair should be shaved off. The decontaminating solutions should be washed off within 3-4 min to prevent additional skin injury. Sodium hypochlorite (5%) or liquid household bleach can be used. If erythema is already present, soap and water are preferred. Blisters should be left intact, but if broken, should be debrided to prevent secondary infection. Cleansing with tap water or saline and the application of dressings is done when needed. Silver sulfadiazine or mafenide acetate can be applied and the wounds treated as burn wounds. Infected skin wounds require antibiotics as appropriate. 

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