Proteases such as trypsin and clostridiopeptidase, which are contained in ointments used for the removal of dead skin on wounds, can be inhibited by silver ions if applied simultaneously. Possible consequences of generalised argyria include interstitial nephritis and anemia. Generalised argyria with silver accumulation in kidneys, liver, and retina has only been found in association with excessive long-term use, or repeated use on severe and heavily inflamed burns. Incorporation of the silver ions can lead to local argyria (discoloration of the skin), especially if the treated area is exposed to ultraviolet light. This reaction is known from other sulfonamides including antibacterials, thiazide diuretics, and sulfonylurea antidiabetics but data on the likelihood of cross-allergies are inconsistent. About 0.1 to 1.0% of people show hypersensitivity reactions such as rashes or erythema multiforme. Burning and painful sensations are not uncommon, but are only temporary.Īpplication to large areas or to severe burns may lead to systemic absorption and lead to adverse effects similar to those of other sulfonamides. Adverse effects Ī noninfection-related clear fluid may form on the wound's surface. For this reason, application of silver sulfadiazine is not recommended for most burns due to altered wound appearance and the frequency of required dressing changes.
In addition to concerns regarding delayed wound healing, silver sulfadiazine is associated with sloughing of the wound surface that makes reassessment of wound depth difficult, and requires daily reapplication. Cochrane has raised concerns about delays in time to wound healing when SSD is used. Other reviews of the evidence have also concluded, " quality of the trials was limited". Another Cochrane systematic review from 2010 concluded, "There is insufficient evidence to establish whether silver-containing dressings or topical agents promote wound healing or prevent wound infection". A Cochrane review from 2013 found that most of the trials that met inclusion criteria for the review had methodological shortcomings and thus are of little use in assessing the efficacy of silver sulfadiazine in the healing of burn injuries. Tentative evidence has found other antibiotics to be more effective in the healing of superficial and partial thickness burn injuries therefore, it is no longer generally recommended. It is on the World Health Organization's List of Essential Medicines. Silver sulfadiazine was discovered in the 1960s. It is not recommended for use in children less than two months of age. It should not be used in pregnant women who are close to delivery. Caution should be used in those allergic to other sulfonamides. Other side effects include low white blood cell levels, allergic reactions, bluish grey discoloration of the skin, red blood cell breakdown, or liver inflammation. Ĭommon side effects include itching and pain at the site of use. Tentative evidence has found other antibiotics to be more effective, and therefore it is no longer generally recommended for second-degree (partial-thickness) burns, but is still widely used to protect third-degree (full-thickness) burns.
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Silver sulfadiazine, sold under the brand Silvadene among others, is a topical antibiotic used in partial thickness and full thickness burns to prevent infection.
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