TABLE 4.

Profile of commonly used topical antimicrobial agentsa

Topical agentPreparationEschar penetrationAntibacterial activitybMajor toxicity
Silver nitrate (AgNO3)0.5% solutionNoneBacteriostatic against aerobic gram-negative bacilli, P. aeruginosa, limited antifungalElectrolyte imbalance
Silver sulfadiazine (Silvodene, Flamazine, Thermazine, Burnazine)1% water-soluble cream (oil-in-water emulsion)NoneBactericidal against aerobic gram-negative bacilli, P. aeruginosa, some C. albicansLeukopenia
Mafenide acetate (Sulfamylon)10% water-soluble cream (oil-in-water emulsion), 5% solutionLimitedBroad spectrum against aerobic gram-negative bacilli, P. aeruginosa, anaerobesMetabolic acidosis
Nanocrystalline silver dressings (Acticoat A.B. dressing, Silverlon)Dressing consisting of two sheets of high-density polyethylene mesh coated with nanocrystalline silverModeratePotent activity against aerobic gram-negative bacilli, P. aeruginosa, aerobic gram-positive bacilli, MRSA, VRE, multidrug-resistant EnterobacteriaceaeLimited toxicity
  • a Data are from references 134, 189, and 298.

  • b VRE, vancomycin-resistant enterococci.