Successful antibiotic penetration of a burn eschar can be achieved with:
a. Mefenide acetate is the antibiotic agent that penetrates burn eschar to reach the interface with the patient’s viable tissue.
b. Mafenide acetate has proved effective against a wide range of gram-positive and gram-negative organisms as well as in anaerobes.
c. This drug actively diffuses through the eschar , thus providing protection in the depth of the eschar.
d. Dressings is not required with the use of mefenide acetate.
e. This agent has the disadvantage that it is quite painful on any partial thickness areas .
f. Also it is a carbonic anhydrase that interferes with renal buffering mechanism.
g. Increased bicarbonate excretion by the kidney occurs simultaneous with hypocapnea secondary to hyperventilation..
h. Acidosis may develop rapidly in patients withpulmonary dysfunction.
i. Occasional hypersensitivity is seen in 5-7% of the patients.
j. Chloride is retained, and metabolic acidosis results.
k. Silver nitrate therapy is accalaimed as the most economical topical agent for the burn.