Sulfamylon (mafenide) is an antibiotic cream that's used on the skin to prevent bacterial infections after serious burns. The typical dosage for Sulfamylon (mafenide) cream is to apply it once or twice a day. Common side effects of Sulfamylon (mafenide) include pain and a burning sensation during application. Mafenide used to be available as a powder for topical solutions, but both brand and generic versions of the solution are no longer approved by the FDA.
Prevention of infection after second- and third-degree burns (add-on treatment)
Sulfamylon (mafenide) is a bacteriostatic antibiotic, meaning it slows bacteria activity and growth instead of killing them (bactericidal). This helps your immune system clear the bacteria from your body.
Source: DailyMed
Prevents bacterial infection in burns
Typically applied only once or twice daily
Can be used on children and adults
Must be used with other medications and therapies for treating burns
Must re-apply if any of it rubs or washes off
Doesn't prevent fungal growth or infections
Wash your hands well before applying this medication or caring for your burn wounds. You want them to be as clean as possible so you don't introduce bacteria that can cause infection.
Apply Sulfamylon (mafenide) while wearing sterile medical gloves. Apply the cream at about 1/16 inch thickness. If it rubs or washes off, re-apply the cream to keep the burn wound covered at all times.
Dressings usually aren't required on top of Sulfamylon (mafenide) cream, but if you do use one, make sure the dressing is only a thin layer.
It's important to bathe or gently shower every day. This helps wash off dead skin cells and helps with healing.
Use Sulfamylon (mafenide) only on burned skin surfaces. This medication shouldn't be taken by mouth.
It isn't known if Sulfamylon (mafenide) gets into breast milk and causes harm to breastfed babies. Tell your provider if you're breastfeeding before using this medication.
Sulfamylon (mafenide) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: G6PD deficiency
If you have a condition called glucose-6-phosphate dehydrogenase (G6PD) deficiency, be sure to talk to your provider before using Sulfamylon (mafenide). Though extremely rare, there have been reports of Sulfamylon (mafenide) causing life-threatening changes in red blood cell counts (anemia), abnormal clotting, and bleeding, in people with this condition.
Risk factors: Sulfite allergy | Sulfa allergy | Asthma
Sulfamylon (mafenide) contains a sulfite ingredient. Sulfites are commonly used as preservatives in medications, foods, and drinks, but some people are allergic to them. Additionally, Sulfamylon (mafenide) contains sulfa. Get medical help right away if you think you're having an allergic reaction (e.g., hives, swelling, difficulty breathing). Let your provider and pharmacist know of all your allergies before using Sulfamylon (mafenide). If you have asthma, it's best to have your rescue inhaler handy when first starting on this medication since sulfite allergies are more common in people with asthma.
Risk factors: Kidney problems | Lung or breathing problems | Burns affecting large parts of the body
Sulfamylon (mafenide) can cause high acid levels in the blood (acidosis) as a side effect, especially if you have kidney problems or need to use a lot of the medication on large burns. Your provider might have you do blood work so they can make sure this doesn't become a serious problem. Let your provider know right away if your breathing gets faster, since this can be a sign of too much acid in your blood.
Since Sulfamylon (mafenide) prevents growth of bacteria, fungi have a better chance of growing in areas where you've applied this medication. This rarely is a serious problem, but let your provider know if your wound symptoms (e.g., pain, redness, swelling) get worse.
Keep the burn area covered with Sulfamylon (mafenide) at all times. Use this cream once or twice daily (also reapply anytime it's removed). Apply enough cream to make it 1/16 inch thick.
Prevention of infection after second- and third-degree burns (add-on treatment)
Preventing bacterial infections in minor cuts, scrapes, and burns
Impetigo - ointment
Bacterial skin infection that happens after skin gets damaged (e.g., from a cut or other wound) - cream
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American Academy of Allergy, Asthma & Immunology. (n.d.). Sulfite and sulfa drugs.
Browning, J. A., et al. (2023). Burn debridement, grafting, and reconstruction. StatPearls.
Elseth, A., et al. (2022). Wound grafts. StatPearls.
Food and Drug Administration. (2022). Mylan Institutional, Inc.; withdrawal of approval of a new drug application for SULFAMYLON® (mafenide acetate, USP) powder for 5% topical solution. Federal Register.
Liu, A. (2022). Viatris pulls decades-old accelerated approval thanks to 'unfeasible' confirmatory trial demand. Fierce Pharma.
Loree, J., et al. (2022). Bacteriostatic antibiotics. StatPearls.
MedlinePlus. (n.d.). Glucose-6-phosphate dehydrogenase deficiency.
Rising Pharma Holdings, Inc. (2021). SULFAMYLON- mafenide acetate cream. DailyMed.
Valley, H., et al. (2012). Adverse reaction to the sulphite additives. Gastroenterology and Hepatology from Bed to Bench.
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