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©2013 UpToDate ® Print Email Antimicrobial agents for the management of superficial partial thickness burns Characteristics/antimicrobial agents Clinical indications Effectiveness Contraindications Adverse effects Silver sulfasalazine (SSD) Small, medium and large surface area burns No evidence to support improved would healing or reduction in bacterial wound infections Decreased colonization of wounds Alleviates pain Burns near eyes Pregnant Breast feeding Newborns <2 months Allergic to sulfonamides Signs of re-epithelialization Skin hypersensitivity Neutropenia Leukopenia Methemoglobinemia SSD plus cerium Small, medium and large surface area burns Improved re-epithelialization over SSD alone Burns near eyes Pregnancy Breast feeding Newborns <2 months Allergic to sulfonamides Signs of re-epithelialization Skin hypersensitivity Neutropenia Leukopenia Methemoglobinemia Combination antibiotic ointments Face Ears Perineum Allergies to sulfonamides Ease of application and of removal Bacterial resistance Allergic reaction Signs of re-epithelialization Yeast colonization Skin hypersensitivity Ototoxicity and nephrotoxicity with Neosporin Mafenide Ears Nose Dense bacterial proliferation Excellent eschar penetration Penetrates cartilage Burns >40 percent total body surface area Metabolic acidosis Painful Inhibits epithelial regeneration Chlorhexidine Only superficial burns Does not interfere with re-epithelialization Can be used with SSD Deep burns Skin hypersensitivity Povidone-iodine Controversial - toxic to fibroblasts Reduces cell proliferation Only when no other agent is available Children under two years Pregnant Breast feeding Thyroid disorders Signs of re-epithelialization Painful Skin hypersensitivities Chemical burn Iodine toxicity Renal failure Acidosis Anaphylaxis