| MAFENIDE ACETATE
Classifications: antibiotic; sulfonamide derivative; Therapeutic:antibiotic
Pregnancy Category: C
5% solution; cream
Topical sulfonamide derivative effective against both gram-positive and gram-negative drugs. Topical applications produce
marked reduction of bacterial growth in vascular tissue. Active in presence of purulent matter and serum and not affected
by changes in pH of tissue environment.
Bacteriostatic against many gram-positive and gram-negative organisms, including Pseudomonas aeruginosa, and certain strains of anaerobes.
Adjunctive therapy in second- and third-degree burns to prevent sepsis.
History of hypersensitivity to mafenide; respiratory (inhalation) injury, pulmonary infection; pregnancy (category C), lactation,
children <3 mo.
Impaired kidney or pulmonary function, burn patients with acute kidney failure.
Route & Dosage
Adult: Topical Apply aseptically to burn areas to a thickness of approximately 15 mm (1/16 in) once or twice daily
- Apply cream or solution aseptically to cleansed, debrided burn areas with sterile gloved hand.
- Cover burn areas with cream at all times. Make reapplications to areas from which cream has been removed as necessary.
- Store in tight, light-resistant containers. Avoid extremes of temperature.
Adverse Effects (≥1%)Hypersensitivity:
Pruritus, rash, urticaria, blisters, facial edema, eosinophilia. Skin: Intense pain, burning, or stinging at application sites,
bleeding of skin, excessive body water loss, delayed eschar separation, excoriation of new skin, superinfections. Hematologic: Hemolytic anemia, bone marrow suppression
No clinically significant interactions established.
Rapidly from burn surface. Peak:
24 h. Metabolism:
Rapidly inactivated in blood to a weak carbonic anhydrase inhibitor. Elimination:
Assessment & Drug Effects
- Monitor vital signs. Report immediately changes in BP, pulse, and respiratory rate and volume.
- Monitor I&O. Report oliguria or changes in I&O ratio and pattern.
- Lab tests: Monitor fluid and electrolyte status throughout therapy; acidbase balance should be monitored in patients
with extensive burns and in those with pulmonary or kidney dysfunction.
- Be alert to S&S of metabolic acidosis (see Appendix F).
- Be alert to evidence of superinfections (see Appendix F), particularly in and below burn eschar.
- Observe carefully; accuracy is critical. It is frequently difficult to distinguish between adverse reactions to mafenide
and the effects of severe burns.
- Note: Allergic reactions have reportedly occurred 1014 d after initiation of mafenide therapy. Temporary discontinuation
of drug may be necessary.
- Report intense local pain to physician; pain caused by drug may require administration of analgesic.
Patient & Family Education
- Apply only a thin dressing over burns unless otherwise directed.
- Therapy is usually continued until healing is progressing well (usually 60 d) or site is ready for grafting (after about
3540 d). It is not withdrawn while there is a possibility of infection unless adverse reactions intervene.
- Report any of the following to the physician immediately: Foul-smelling drainage from wounds, bleeding at wound site, unexplained