Mafenide
Class: Local Anti-infectives, Miscellaneous
ATC Class: D06BA03
VA Class: DE101
CAS Number: 13009-99-9
Brands: Sulfamylon
Introduction
Synthetic anti-infective agent.
Uses for Mafenide
Treatment and Prevention of Burn Infections
Mafenide acetate cream is used topically as adjunctive therapy in second- and third-degree burns to prevent septicemia caused by susceptible organisms, especially Pseudomonas aeruginosa.
Control of bacterial growth may prevent conversion of second-degree (partial-thickness) wounds to third-degree (full-thickness) wounds; however, delayed eschar separation reported.
Although controlled, comparative studies are lacking, mafenide and silver sulfadiazine are considered by many clinicians to be among the topical anti-infective agents of choice in burn patients.
Mafenide appears to penetrate burn eschar better than silver sulfadiazine and may be more effective in minimizing the growth of bacteria and early treatment of wound sepsis. Unlike mafenide, silver sulfadiazine does not alter acid-base balance and does not have a limited duration of therapy and area of topical application; softening action of silver sulfadiazine cream may aid in eschar removal and preparation of wound for grafting.
Alternative therapies include wet dressings of 0.5% silver nitrate; appears to be of equal efficacy as mafenide cream; mafenide cream may cause more pain on application.
Mafenide acetate solution is used topically as adjunctive therapy to control bacterial infections under moist dressings over meshed autografts on excised burn wounds.
Mafenide Dosage and Administration
Administration
Topical Administration
Administer topically as a cream or solution; not for injection.
Cream
Apply cream only after instituting appropriate measures to control shock and pain.
Apply to cleansed, debrided burn wounds using a sterile, gloved hand.
Bathe patient daily, preferably in a whirlpool bath, to aid in debridement.
Dressings generally not required; if necessary, use only a thin layer. Some clinicians apply dressings when the eschar begins to separate (16–20 days) to expedite the separation of the eschar.
Solution
Apply topically as a 5% reconstituted solution.
Consult manufacturer’s information for complete directions for use.
Reconstitution
Reconstitute 50-g packet of sterile mafenide acetate powder with 1 L of sterile water for irrigation or 0.9% sodium chloride irrigation by adding powder to solution in suitable container and mixing until completely dissolved. (See Storage under Stability.)
Dosage
Available as mafenide acetate; dosage expressed in terms of mafenide.
Each gram of mafenide acetate cream provides the equivalent of 85 mg of mafenide.
Pediatric Patients
Treatment and Prevention of Burn Infections
Topical (Cream)
Children: Apply sufficient amount to cover affected area to a thickness of 1/16th inch, once or twice daily. Thicker application is not recommended.
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