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Topical antimicrobial (silver-sulfonamide)

Silver Sulfadiazine 1% Cream

Brand names: Flamazine (1% cream)

Used in: Burns

Silver sulfadiazine is a topical antibacterial cream used to prevent and treat infection in burns and certain chronic wounds and leg ulcers.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It releases silver ions that act on the bacterial cell wall and membrane, combined with the sulphonamide component, giving broad-spectrum antibacterial activity against organisms including Pseudomonas.

Prescribing in practice

  • Contraindicated in patients with sulphonamide hypersensitivity and avoided in pregnancy near term, in neonates and in infants because of the risk of kernicterus.
  • Use over large areas may lead to systemic sulphonamide absorption and, rarely, leucopenia or argyria with prolonged use.
  • May interact with topical proteolytic (enzymatic) debriding agents, reducing their activity.

Monitoring

For extensive or prolonged application, monitor full blood count and watch for signs of systemic absorption and hypersensitivity.

Counselling the patient

  • A transient grey or black skin discolouration may occur at the application site.
  • Report rash, fever or other signs of an allergic reaction.
  • The cream may stain clothing and bedding.

Evidence & guidelines

Silver sulfadiazine is an established topical antimicrobial for burns, supported by long-standing clinical use, though evidence for improved healing over modern dressings is limited.

Reference: NICE Burn Wound Management Guidelines; British Burns Association Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Pathways