Mafenide

MAFENIDE ACETATE

Complete information including dosage, side effects, interactions and pregnancy & breast feeding warnings for patient and professional use.

Overview and uses

Mafenide acetate is an antibiotic used topically to prevent infections in severe burn wounds.

Indication (uses):

  • For the treatment of conjunctivitis and other superficial ocular infections due to susceptible microorganisms, and as an adjunctive in systemic sulfonamide therapy of trachoma: Escherichia coli, Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus (viridans group), Haemophilus influenzae, Klebsiella species, and Enterobacter species.
  • Topically applied sulfonamides do not provide adequate coverage against Neisseria species, Serratia marcescens and Pseudomonas aeruginosa. A significant percentage of staphylococcal isolates are completely resistant to sulfa drugs.

Pharmacological classification: topical anti bacterial

Brand names: Sulfamylon

Dosage form:

  • Available as topical cream, topical powder for reconstitution and compounding powder.

Mechanism of action:

The exact mechanism for anti bacterial action of Mafenide acetate is not known. The mechanism of action of mafenide is different from that of the sulfonamides. Mafenide is not antagonized by pABA, serum, pus or tissue exudates, and there is no correlation between bacterial sensitivities to mafenide and to the sulfonamides. Its activity is not altered by changes in the acidity of the environment. The osmolality of the 5% topical solution is approximately 340 mOsm/kg.

Dosage

  • Mafenide topical solution
    • Cover the burnt area with one layer of fine mesh gauze.
    • Cut an eight ply burn dressing to the size of the graft and wet it with Mafenide acetate solution using a syringe or irrigation tube until leaking is noticeable
    • The gauze dressing should be kept wet by irrigating the gauze dressing with a syringe or by injecting into the irrigation tube. This should be done by injecting the solution into irrigation tube every 4 hours or as and when required. If irrigation tube is not used, gauze dressing should be moistened every 6 to 8 hours or as and when required.
  • Mafenide topical cream
    • Apply the cream to clean and debrided wounds using a clean and sterile glove, once or twice a day, at a thickness not more than 1/16 inch.

Pediatric use

The safety and efficacy of Mafenide acetate has been established in children in age group of 3 months to 16 years.

Geriatric use

Data not available due to insufficient studies on safety and efficacy of Mafenide for burn wounds in elderly patients.

Side effects or adverse effects

  • Mafenide produces burning sensation and severe pain when applied to raw surface.
  • Allergic reactions, particularly rashes may also occur.
  • Mafenide and its metabolites are carbonic anhydrase inhibitors. This alkalinizes urine, can cause acidosis and hyperventilation.
  • Fatal hemolytic anemia with disseminated intravascular coagulation, presumably related to a glucose-6-phosphate dehydrogenase deficiency, has been reported following therapy with mafenide acetate.
  • Fungal colonization may occur concomitantly with reduction of bacterial growth in the burn wound. However, systemic fungal infection through the infected burn wound is rare
  • Bone marrow depression and acute attack of porphyria has also been reported.
  • Erythema, skin maceration from prolonged wet dressings, facial edema, swelling, hives, blisters and eosinophilia have also been reported.
  • Tachypnea, decrease in pCO2 and increase in serum chloride have also been reported.

Warnings

  • Fatal hemolytic anemia with disseminated intravascular coagulation, presumably related to a glucose-6-phosphate dehydrogenase deficiency, has been reported following therapy with mafenide acetate. Bacterial resistance to sulfonamides may also develop.
  • Mafenide is contra indicated in patients who are hypersensitive to Mafenide.
  • Caution should be exercised in using Mafenide for burns in patients with acute renal failure.

Pregnancy & breast feeding warnings

Pregnancy: Category C, which means animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Nursing:

  • It is not known whether Mafenide acetate is excreted in human breast milk or not.
  • Considering the potential for serious side effects in nursing infants, a decision should be made whether to discontinue Mafenide or to discontinue feeding.

Interactions

Drug – drug interactions

  • Data not available.

Click here to go to Mafenide acetate forums.

Reference

“Product information. Sulfamylon (Mafenide acetate topical solution).” Bertek pharmaceuticals, Inc., sugar land, TX.

Note: The sole purpose of every information shared on this article is to bring awareness. Do not use this information as a medical advice or prescription advice or as a tool for the treatment, diagnosis or prevention of the disease.

By |2018-12-29T07:02:51+00:00May 2nd, 2017|medicines|Comments Off on Mafenide

About the Author:

B. Pharm (K.L.E. society's S.V.V. Patil College of Pharmacy, Bengaluru) M. Pharm (Maharishi Arvind Institute of Pharmacy, Jaipur)

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