Sulfadiazine

Sulfadiazine Belongs to the class of topical sulfonamides used in the treatment of dermatological diseases

Sulfadiazine is a topical antibiotic used in the treatment of burn wound infection, infected leg ulcer and other topical diseases.

Sulfadiazine is Rapidly and well absorbed from the gastrointestinal tract. Bioavailability:95.4% However, parenteral administration is difficult, since the soluble sulfonamide salts are highly alkaline and irritating to the tissues. The sulfonamides are widely distributed throughout all tissues. High levels are achieved in pleural, peritoneal, synovial, and ocular fluids Volume of distribution: Approx 2.2- 4.3 L. It get excreted Via urine (as unchanged drug and metabolites). Elimination half-life: 7-14 hours (range: 1.4-2.5 hours).

Sulfadiazine shows common side effects like anxiety, cold sweats, depression etc.

Sulfadiazine is available in the form of tablet and topical cream.

Sulfadiazine is available in India, Germany, Canada, Italy.

Sulfadiazine is a competitive inhibitor of the bacterial enzyme dihydropteroate synthetase. This enzyme is needed for the proper processing of para-aminobenzoic acid (PABA) which is essential for folic acid synthesis. The inhibited reaction is necessary in these organisms for the synthesis of folic acid.

Sulfadiazine is available in the form of tablets and topical cream .

Sulfadiazine is a topical antimicrobial. Agent used in the treatment of burn wound infection, leg ulcers and fingertip injury.

One of the short-acting sulfonamides used in combination with pyrimethamine to treat toxoplasmosis in patients with acquired immunodeficiency syndrome and in newborns with congenital infections.

Sulfadiazine is approved for use in the following clinical indications

• Burn wound infection
• Prophylaxis of burn wound infection
• Infected leg ulcers
• Infected pressure ulcers

As a topical antibiotic

Burn wound infection

Adult: Apply over the affected area to a depth of 3-5 mm 1-2 times daily. Burn site should always be covered with cream, re-apply to areas removed by patient activity. Dressings may be used as necessary.

Sulfadiazine is available in various strengths

• Tablets 500mg and 1g
• Cream 1%

Sulfadiazine is available in the form of tablet and cream.

Sulfadiazine is contraindicated in patients who are hypersensitive to silver sulfadiazine or any of the other ingredients in the preparation Because sulfonamide therapy is known to increase the possibility of kernicterus, Sulfadiazine should not be used on pregnant women approaching or at term, on premature infants.

Pregnancy category B

Silver sulfadiazine is not recommended during near term pregnancy due to the potential risk of neonatal hyperbilirubinemia and kernicterus.

• Common Adverse effects

Fungal or bacterial superinfection including C.difficile-associated diarrhoea (CDAD) and pseudomembranous colitis, leucopenia (prolonged use); delayed eschar separation..

• Less Common Adverse effects

Anaphylactic reactions, fixed drug eruption.

• Rare Adverse effects

Argyria (prolonged use/large area of application).

Potentially Fatal: Stevens-Johnson syndrome.

Enhances the penetration of antibiotic agents (e.g. amoxicillin, erythromycin, cefuroxime) into bronchial secretions.

The common side effects of Sulfadiazine include the following Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN), acute generalised exanthematous pustulosis.

Symptoms: Gastrointestinal disturbances such as gastralgia, nausea, and vomiting.

Management: Supportive treatment. May perform gastric lavage, then closely observe the patient.

Pharmacodynamic

Sulfadiazine is a sulfonamide antibiotic. The sulfonamides are synthetic bacteriostatic antibiotics with a wide spectrum against most gram-positive and many gram-negative organisms. However, many strains of an individual species may be resistant. Sulfonamides inhibit multiplication of bacteria by acting as competitive inhibitors of p-aminobenzoic acid in the folic acid metabolism cycle. Bacterial sensitivity is the same for the various sulfonamides, and resistance to one sulfonamide indicates resistance to all. Most sulfonamides are readily absorbed orally. However, parenteral administration is difficult, since the soluble sulfonamide salts are highly alkaline and irritating to the tissues. The sulfonamides are widely distributed throughout all tissues. High levels are achieved in pleural, peritoneal, synovial, and ocular fluids

• https://www.uptodate.com/contents/topical-agents-and-dressings-for-local-burn-wound-care
• https://www.mims.com/india/drug/info/silver sulfadiazine?type=full
• https://go.drugbank.com/drugs/DB00359