Mafenide: Indication, Dosage, Side Effect, Precaution

This information is not country-specific. Please refer to the Malaysia prescribing information.

Generic Medicine Info

Indications and Dosage

Topical/Cutaneous
Adjunct in the treatment of infection in second degree burn, Adjunct in the treatment of infection in third degree burn

Adult: As 8.5% cream: Apply a layer approx ¹/₁₆ inch 1-2 times daily. Continue until wound healing progresses or burn site ready for grafting. As 5 % soln: Wet an 8-ply burn dressing w/ soln and cover graft area. Keep dressing wet by using syringe or irrigation tubing (4 hrly or as necessary) or by moistening the dressing (6-8 hrly or as necessary). Continue until autograft vascularisation occurs and wound healing progresses. Wound dressing may be left in place for up to 5 days.
Child: As 8.5% cream: Same as adult dose. As 5% soln: ≥3mth Same as adult dose.

Reconstitution

Powd for soln: Add 50 g of mafenide to 1000 mL of sterile water or NaCl 0.9% for irrigation to provide a 5% soln. Mix until dissolved.

Contraindications

Hypersensitivity to sulfonamides.

Special Precautions

Patient w/ G6PD deficiency, pulmonary dysfunction. Renal impairment. Childn. Pregnancy and lactation.

Adverse Reactions

Significant: Hyperventilation w/ resulting resp alkalosis, metabolic acidosis, fungal or bacterial superinfection.
Resp: Dyspnoea, decreased pCO₂.
Endocrine: Hyperchloraemia.
Haematologic: Eosinophilia, porphyria, bleeding.
Dermatologic: Pain or burning sensation, rash, pruritus, facial oedema, swelling, urticaria, blisters, erythema, excoriation, hives, blisters.

Pregnancy Category (US FDA)

Topical: C

Monitoring Parameters

Monitor acid-base balance, signs of infection and healing.

Action

Description: Mafenide is a short-acting sulfonamide topical antibacterial agent that has a wide spectrum of activity. It has no definite mechanism of action, however, it appears to interfere w/ bacterial cellular metabolism. It has bacteriostatic action against many gm+ve and gm-ve organisms, including Pseudomonas aeruginosa and some anaerobes.
Pharmacokinetics:
Absorption: Absorbed systemically from burned surface. Time to peak plasma concentration: 2 -4 hr (cream).
Metabolism: Metabolised to p-carboxybenzenesulfonamide, a weak carbonic anhydrase inhibitor.
Excretion: Via urine, as metabolites.

Chemical Structure

Storage

Powd for soln: Store between 15-30°C. Cream: Store below 40°C. Protect from excessive heat.

MIMS Class

Topical Antibiotics

ATC Classification

D06BA03 - mafenide ; Belongs to the class of topical sulfonamides used in the treatment of dermatological diseases.

References

Anon. Mafenide. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 05/07/2017.

Buckingham R (ed). Mafenide. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 05/07/2017.

Mafenide Acetate Powder, for Solution (Par Pharmaceutical Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 05/07/2017.

McEvoy GK, Snow EK, Miller J et al (eds). Mafenide Acetate (Topical). AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 05/07/2017.

Sulfamylon Cream (Mylan Institutional Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 05/07/2017.

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