Drug Guide
Mafenide Acetate
Classification
Therapeutic: Antimicrobial, Topical agent for burn infections
Pharmacological: Sulfonamide (Antibiotic)
FDA Approved Indications
- Treatment of burn wound infections, especially in adult and pediatric patients.
Mechanism of Action
Mafenide acetate inhibits bacterial dihydropteroate synthase, blocking folic acid synthesis essential for bacterial growth, thus exhibiting bacteriostatic activity.
Dosage and Administration
Adult: Apply a 1/16-inch thick layer of Sulfamylon cream over the entire burn area, usually 2-4 times daily, depending on clinical response.
Pediatric: Use same as adult dosing; monitor closely due to potential for systemic absorption.
Geriatric: Same as adult; monitor for any signs of systemic toxicity or hypersensitivity.
Renal Impairment: Careful monitoring; dose adjustments may not be specified but observe for toxicity due to decreased clearance.
Hepatic Impairment: No specific adjustments, but general caution advised.
Pharmacokinetics
Absorption: Minimal systemic absorption when used topically; some absorption can occur through burned skin.
Distribution: Primarily remains localized; some systemic distribution possible in extensive burns.
Metabolism: Metabolized minimally; largely remains unchanged.
Excretion: Excreted primarily in urine.
Half Life: Not well-defined; systemic clearance is rapid once absorbed.
Contraindications
- Known hypersensitivity to sulfonamides or any component of the formulation.
Precautions
- Use with caution in patients with renal or hepatic impairment, as systemic absorption may occur; monitor closely.
- Pregnancy and lactation: Use only if clearly needed; consult risk-benefit ratio.
Adverse Reactions - Common
- Local burning sensation, itching, or rash (Common)
- Pain or blistering at application site (Uncommon)
Adverse Reactions - Serious
- Metabolic acidosis (Rare)
- Hypersensitivity reactions including Stevens-Johnson syndrome (Very rare)
Drug-Drug Interactions
- Potential increased risk of hypersensitivity reactions with other sulfonamides or cross-reactive drugs.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Assess burn wound regularly for signs of infection, allergic reaction, or systemic toxicity.
Diagnoses:
- Impaired skin integrity related to burn injury and topical application.
Implementation: Apply as prescribed, ensuring even coverage. Monitor for adverse reactions and wound healing.
Evaluation: Monitor wound healing progress, watch for adverse reactions, and assess patient comfort.
Patient/Family Teaching
- Instruct on proper application technique and frequency.
- Warn about possible local burning or rash, and to report any systemic symptoms.
- Advise to avoid self-medicating or applying other topical agents unless directed by healthcare provider.
Special Considerations
Black Box Warnings:
- None specifically for Mafenide acetate.
Genetic Factors: None reported.
Lab Test Interference: May cause false positive tests for glucose in urine using certain dipstick methods.
Overdose Management
Signs/Symptoms: Potential systemic toxicity, metabolic acidosis, hypersensitivity reactions.
Treatment: Discontinue use immediately, provide supportive care, and treat symptoms as indicated. Hemodialysis may be considered in severe systemic toxicity.
Storage and Handling
Storage: Store at room temperature, away from direct light and moisture.
Stability: Stable under recommended conditions for the shelf life specified.