Dosing and uses of Sulfamylon (mafenide)
Burn Treatment
Cream
- Apply to cleaned, debrided area qD-BID at thickness ~1/16 inch
- Ensure burned area covered with cream at all times-reapply PRN
Topical solution
- Cover grafted area with 1 layer of gauze
- Wet 8-ply burn dressing w/ soln until leakage observed; apply, secure & wrap as necessary
- With irrigation tubing: keep gauze dressing wet, by irrigating with syringe or injecting solution into irrigation tubing q4hr or PRN
- Not using irrigation tubing: moisten gauze q6-8hr or PRN
- Wound dressings may be left undisturbed for up to 5 d
Other Indications & Uses
Prevention of septicemia (esp by Pseudomonas aeruginosa) following 2nd/3rd degree burns
Pediatric dosage forms and strengths
Burn Treatment
Cream
- <2 yo: Safety & efficacy not established
- >2 yo: Apply to cleaned, debrided area qD-BID at thickness ~1/16 inch; ensure burned area covered with cream at all times-reapply PRN
Topical solution
- Cover grafted area with 1 layer of gauze
- Wet 8-ply burn dressing with soln until leakage observed; apply, secure & wrap as necessary
- With irrigation tubing: keep gauze dressing wet, by irrigating with syringe or injecting solution into irrigation tubing q4hr or PRN
- Not using irrigation tubing: moisten gauze q6-8hr or PRN
- Wound dressings may be left undisturbed for up to 5 d
Sulfamylon (mafenide) adverse (side) effects
Frequency not defined
Application site rxns
Allergic rxns
Systemic acidosis w/ tachypnea
Warnings
Cautions
Hypersensitivity
ARF, lung problems, blood dyscrasias
E. coli & Proteus spp. appear to be less sensitive
Pregnancy/women of childbearing potential-not recommended in women of childbearing potential unless burned area >20% BSA or benefits justify possible risks to the fetus
G-6-PD deficiency; may result in hemolytic anemia
Pregnancy and lactation
Pregnancy category: C
Lactation: not known whether distributed into breast milk, discontinue drug or do not nurse
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Sulfamylon (mafenide)
Absorption: yes
Metabolism: rapidly to p-carboxybenzenesulfonamide
Excretion: p-carboxybenzenesulfonamide in urine, mafenide undetected in urine
Mechanism of action
Bacteriostatic, precise mechanism unclear-appears to interfere w/ bacterial metabolism
