Not Medical Advice: The National Institutes of Health recommends Bacitracin as a good alternative to silver sulfadiazine (Silvadene) for burn patients with a sulfa allergy.
Bacitracin is a mixture of related cyclic polypeptides produced by organisms of the licheniformis group of Bacillus subtilis var Tracy, isolation of which was first reported in 1945.
Bacitracin zinc is effective to promote regenerative healing when topically applied to wounds in concentrations from about 5% to 8%. The bacitracin zinc can be applied in a hydrophilic or hydrophobic carrier, and is advantageously impregnated in an absorbent pad.
According to the American Academy of Family Physicians, superficial burns do not require infection prophylaxis, but all other burns should receive topical prophylaxis. Classically, silver sulfadiazine cream (Silvadene) is used to prevent burn infections. This agent should never be used on the face or in patients with sulfonamide hypersensitivity. Because of the risk of sulfonamide kernicterus, silver sulfadiazine should not be used in pregnant women, newborns or nursing mothers with infants younger than two months of age.
Alternatives to topical antibiotics include biologic dressings (pigskin, human allograft) and bismuth-impregnated petroleum gauze or Biobrane dressings. The advantage of these dressings is that they are applied only once. As a result, patients are spared the pain that typically accompanies dressing changes.
Biologic dressings are associated with lower infection rates and faster healing rates than silver sulfadiazine. However, these dressings are expensive, difficult to apply and not always readily available. If used, biologic dressings should be applied within the first six hours after the burn is sustained. The initial application may loosen by the following day, necessitating reapplication. Thereafter, these dressings gradually peel off as skin epithelializes underneath them. Early separation of the dressing from the skin indicates the presence of a deeper wound (requiring surgical treatment) or an infection.
Bismuth-impregnated petroleum gauze and Biobrane dressings appear to be advantageous treatments and are acceptable for use in young children with superficial partial-thickness burns. Both of these dressings are applied as a single layer over the burn and are then covered with a bulky dressing. The bulky dressing should be changed every other day, typically in a physician's office, with close assessment of the wound for signs of infection.
Check out Ten Top Tips Management of Burn Wounds, shared by Wounds International.