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Topical antimicrobial (sulfonamide + silver)

Sulfadiazine silver

Brand names: Flamazine

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 active against the bacterial cell wall and membrane, together with a sulphonamide component, providing broad-spectrum antibacterial cover including against Pseudomonas.

Prescribing in practice

  • Contraindicated in sulphonamide hypersensitivity and avoided in pregnancy near term, in neonates and in infants because of the risk of kernicterus.
  • Application to large areas can cause systemic sulphonamide absorption and, rarely, leucopenia, with argyria reported after prolonged use.
  • May reduce the activity of concurrently applied enzymatic wound debriding agents.

Monitoring

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

Counselling the patient

  • Temporary greyish skin discolouration at the site of application can occur.
  • Report rash, fever or other features of an allergic reaction.
  • The cream may stain clothing and bedding.

Evidence & guidelines

Silver sulfadiazine is a long-established topical antimicrobial for burns, supported by extensive clinical use rather than a single landmark trial.

Reference: UK burns 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