TABLE 4.

Profile of commonly used topical antimicrobial agents^a

Topical agent	Preparation	Eschar penetration	Antibacterial activityb	Major toxicity
Silver nitrate (AgNO3)	0.5% solution	None	Bacteriostatic against aerobic gram-negative bacilli, P. aeruginosa, limited antifungal	Electrolyte imbalance
Silver sulfadiazine (Silvodene, Flamazine, Thermazine, Burnazine)	1% water-soluble cream (oil-in-water emulsion)	None	Bactericidal against aerobic gram-negative bacilli, P. aeruginosa, some C. albicans	Leukopenia
Mafenide acetate (Sulfamylon)	10% water-soluble cream (oil-in-water emulsion), 5% solution	Limited	Broad spectrum against aerobic gram-negative bacilli, P. aeruginosa, anaerobes	Metabolic acidosis
Nanocrystalline silver dressings (Acticoat A.B. dressing, Silverlon)	Dressing consisting of two sheets of high-density polyethylene mesh coated with nanocrystalline silver	Moderate	Potent activity against aerobic gram-negative bacilli, P. aeruginosa, aerobic gram-positive bacilli, MRSA, VRE, multidrug-resistant Enterobacteriaceae	Limited toxicity

^aData are from references 134, 189, and 298.

^bVRE, vancomycin-resistant enterococci.