A Retrospective Review of Silver Sulfadiazine Use in Patients With Sulfa-Allergic Burns at a Regional Burn Center.

Background Silver sulfadiazine is the most common topical antimicrobial used in burn management. The intent of this retrospective review is to examine the safety of silver sulfadiazine use in documented sulfa-allergic burn patients at a level one trauma hospital and regional burn center. Methods Institutional review board approval was obtained for electronic chart review of all patients who presented to a level one burn center between 2018 and 2022. Charts were reviewed, and exclusion criteria were applied. Patients included in the study had documented burns treated by burn team providers, application of topical silver sulfadiazine for primary burn management, and a documented sulfa allergy. Chart review identified 71 patients who met the stated criteria out of 2,654 patients treated over a five-year period. Results None of the 71 patients suffered an adverse reaction to silver sulfadiazine used for primary burn care. There were no documented systemic or anaphylactic reactions, hives, or additional adverse reactions after administration. No cessation of the medication was documented due to intolerance. Conclusions It is reasonable for providers to have a discussion with their sulfa-allergic burn patients about the risks, benefits, and alternatives of using silver sulfadiazine if they feel its use is indicated.