Whenever necessary, the cream should be reapplied to any areas from which it has been removed by patient activity. The cream should be applied once to twice daily to a thickness of approximately 1/16 inch. The burn areas should be covered with SILVADENE Cream 1% at all times. The burn wounds are then cleansed and debrided, and SILVADENE Cream 1% (silver sulfadiazine) is applied under sterile conditions. Prompt institution of appropriate regimens for care of the burned patient is of prime importance and includes the control of shock and pain.However, reduction in bacterial colonization has caused delayed separation, in some cases necessitating escharotomy in order to prevent contracture. Reduction in bacterial growth after application of topical antibacterial agents has been reported to permit spontaneous healing of deep partial-thickness burns by preventing conversion of the partial thickness to full thickness by sepsis.Other infrequently occurring events include skin necrosis, erythema multiforme, skin discoloration, burning sensation, rashes, and interstitial nephritis.An increased incidence of leukopenia has been reported in patients treated concurrently with cimetidine. Recovery is not influenced by continuation of silver sulfadiazine therapy. Rebound to normal leukocyte levels follows onset within 2 to 3 days. Maximal white blood cell depression occurs within 2 to 4 days of initiation of therapy. Leukopenia associated with silver sulfadiazine administration is primarily characterized by decreased neutrophil count. Several cases of transient leukopenia have been reported in patients receiving silver sulfadiazine therapy.The use of SILVADENE Cream 1% (silver sulfadiazine) in some cases of glucose-6-phosphate dehydrogenase-deficient individuals may be hazardous, as hemolysis may occur.However, the incidence of clinically reported fungal superinfection is low. Fungal proliferation in and below the eschar may occur.If allergic reactions attributable to treatment with silver sulfadiazine occur, continuation of therapy must be weighed against the potential hazards of the particular allergic reaction.
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