Silver sulphadiazine cream

Absorption of silver nitrate across intact skin has been demonstrated in guinea pigs and is similar to that of intact human skin (Wahlberg 1965). The amount absorbed was estimated to be approximately 1 % of the applied dose within 5 hours of exposure. Silver administered in the form of silver sulphadiazine cream was minimally absorbed through both the intact and burned skin of rats and distributed throughout the body (Sano et al. 1982). The absorption of silver increased through burned skin after blister removal. The authors did not determine the percentage of the applied dose that was absorbed (Sano et al. 1982). 

Following the topical application of silver nitrate for the treatment of burns in two humans, silver was distributed to the muscles (0.03-2.3 ppm), liver (0.44 ppm), spleen (0.23 ppm), kidney (0.14 ppm), heart (0.032-0.04 ppm), and bones (0.025 ppm) (Bader 1966). No studies were located that quantitated the distribution of silver in animals following dermal exposure to silver or its compounds. However, Sano et al. (1982) detected silver in the same tissues of rats following topical application of silver sulphadiazine cream. 

Bums. Infection may be reduced by application of silver sulphadiazine cream. Substantial absorption can occur from any raw surface and use of aminoglycoside, e.g. neomycin, preparations can cause ototoxicity. 

Shahzad, M. N. and Ahmed, N. 2013. Effectiveness of Aloe vera Gel compared with 1% silver sulphadiazine cream as bum wound dressing in second degree bums. Journal of Pakistan Medical Association, 63 (2), pp. 225—230. 

The first record of the medicinal but not antimicrobial use can be found in writings around 750 AD. An early scientific paper by Crede has already been alluded to [4] it involved the use of silver in the treatment of inflammation of the eyes (ophthalmia neonatorum) in new-born infants. In a further paper [8], silver was advocated as an internal antiseptic. During the following years, silver nitrate, citrate, lactate and proteinate have appeared in pharmacopoeias and formularies around the world. A silver nitrate lotion appeared in older editions of the British National Formulary. In the latest issues, however (no. 26, 1993 onwards [9]) only silver sulphadiazine is to be found. The USP XXII [10] lists silver sulphadiazine (used as a cream) and silver nitrate (used as an ophthalmic solution). 

For areas of erythema and minor blistering, bland lotions (e.g. calamine) have been suggested. Silver sulphadiazine (Flamazine) 1% cream was used in the management (1986) of Iranian mustard gas casualties (Willems, 1989). This probably had value in reducing skin infection. 

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