Burna 1%

Indications:
Burna cream is indicated for:

• Topical prophylaxis against bacterial colonization and infection in burn wounds.
• Topical antibacterial management of certain contaminated or infection-prone wounds, other than burns.
  Consult a registered medical professional before use.

Pharmacology:
Silver Sulfadiazine’s antibacterial action is not fully understood, but it involves several mechanisms:

• It causes structural changes in the bacterial cell membrane, weakening the cell wall and reducing the viability of sensitive strains.
• The silver component binds to bacterial DNA, preventing bacterial cell proliferation, but its ratio to mammalian DNA is low, so it doesn’t interfere with epithelial cell regeneration.
• Sulfadiazine provides bacteriostatic effects, inhibiting bacterial growth.
• In adults, up to 10% of sulfadiazine may be absorbed, and 60-85% of the absorbed amount is excreted in urine. In children with burn injuries, the urinary concentration of sulfadiazine was found to be 31.8 mg/L for those with 13% body surface area burns.

Dosage & Administration:

• Burn Wounds: Cleanse the burn wounds and apply Burna cream over the affected area.
  • Apply 1-2 times daily, with a layer of approximately 1/16 inch (1.5 mm) thickness.
  • Ensure the burn area is covered with the cream at all times. Reapply whenever it is removed due to patient activity.
  • Dressings may be used if necessary, but reapply after hydrotherapy.
  • Continue the treatment until satisfactory healing occurs or until the burn site is ready for grafting.
  • Do not withdraw the cream from therapy if infection is still a risk, unless a significant adverse reaction occurs.
    Consult a registered medical professional before use.

Interaction:

• Enzymatic debriding agents: Burna may inactivate these agents, so it’s generally not recommended to use them together.
• Oral hypoglycemic agents and phenytoin: In patients with large burns, where serum sulfadiazine levels may increase, blood levels of hypoglycemic agents and phenytoin should be monitored, as their effects may be potentiated.
• Cimetidine: Co-administration with cimetidine may increase the incidence of leukopenia in patients with large burns.

Contraindications:

• Hypersensitivity to Silver Sulfadiazine or any ingredients in the preparation.
• Should not be used on pregnant women nearing term, premature infants, or newborn infants within the first 2 months of life.

Side Effects:

• Transient leukopenia (temporary low white blood cell count) has been reported in some patients.
• Other infrequent side effects include:
  • Skin necrosis
  • Erythema multiforme
  • Skin discoloration
  • Burning sensation
  • Rashes
  • Interstitial nephritis (kidney inflammation)

Pregnancy & Lactation:

• Pregnancy Category B: Use during pregnancy should only occur if clearly justified, especially in women approaching term.
• It is unknown whether Silver Sulfadiazine is excreted in human milk. A decision must be made whether to discontinue nursing or to discontinue the drug, based on the importance of the drug to the mother.
• Pediatric Use: Safety and effectiveness in pediatric patients have not been established.

Precautions & Warnings:

• If hepatic or renal function is impaired, the drug’s elimination may decrease, leading to accumulation. Discontinuation should be considered if necessary.
• Silver Sulfadiazine may inactivate proteolytic enzymes used for debridement, so caution is advised when using them together.
• In patients with large burn areas, serum sulfadiazine concentrations may approach therapeutic levels (8-12 mg%), so it’s advisable to monitor serum sulfa concentrations.
• Renal function should be closely monitored, and urine should be checked for sulfa crystals.

Therapeutic Class:

• Topical Antibiotic Preparations

Storage Conditions:

• Store below 30°C, away from light and moisture.
• Keep out of the reach of children.