Topical antimicrobial (sulfonamide + silver)
Sulfadiazine silver
Brand names: Flamazine
Adult dose
Dose: Apply 3–5mm thick layer to clean burn surface OD-BD; cover
Route: Topical
Frequency: OD-BD
Clinical pearls
- Burns (partial-thickness), pressure ulcers — antimicrobial coverage incl. Pseudomonas
- Avoid on face; silver staining — counsel
Contraindications
- Sulfonamide hypersensitivity
- G6PD deficiency
- Pregnancy near term/breastfeeding (theoretical)
- Premature/term <2 months
- Extensive burns (caution — systemic absorption)
Side effects
- Argyria
- Leukopenia
- Hypersensitivity
- Methaemoglobinaemia
- Hepatotoxicity (extensive use)
Interactions
- Topical proteolytic enzymes (inactivation)
Reference: BNF; UK burns guidelines; https://bnf.nice.org.uk/drugs/sulfadiazine-silver/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Suspicious Pigmented Lesion — Melanoma Pathway · NICE NG14 2015 / BAD
- Cellulitis and Erysipelas · NICE NG141 2019 / CREST
- Psoriasis — Severity Assessment and Step-Up Therapy · NICE NG153 2019 / BAD
- Atopic Eczema — Assessment and Step-Up Therapy · NICE NG95 2023
- Urticaria and Angioedema · BSACI / EAACI Guidelines 2022
- Acne Vulgaris — Grading and Treatment · NICE NG198 2021 / BAD