Which antibiotic dressings are used to treat necrotizing fasciitis?

Updated: Oct 17, 2018
  • Author: Steven A Schulz, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

The current formulation of silver sulfadiazine contains a lipid-soluble carrier, polypropylene glycol, which has certain disadvantages, including pseudoeschar formation. When this antibacterial agent is formulated with poloxamer 188, the silver sulfadiazine can be washed easily from the wound because of its water solubility, making dressing changes considerably more comfortable.

If the patient is allergic to sulfa, alternative agents include Polysporin, Bacitracin, and Bactroban. While these agents are relatively inexpensive, they may induce allergies.

Mafenide is an alternate agent that penetrates eschar more effectively than silver sulfadiazine. Consequently, it is frequently used on infected wounds that do not respond to silver sulfadiazine. Use mafenide with caution because it can induce metabolic acidosis.


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