Topical antimicrobials and antifungals
| Drug monograph · NCLEX study reference | |
| Trade names | Bactroban, Silvadene |
|---|---|
| Therapeutic class | Topical antibacterial and antifungal |
| Pharmacologic class | Topical anti-infectives |
| Onset / peak / duration | Local effect over days. |
| Half-life / level | Minimal systemic absorption. |
| High-alert (ISMP) | No |
| Black box warning | None |
| Antidote / reversal | Discontinue. |
| Pregnancy / lactation | Avoid silver sulfadiazine near term. |
Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.
Topical antimicrobials and antifungals (brand names Bactroban, Silvadene) — Topical antibacterial and antifungal; Topical anti-infectives.
Identification
- Therapeutic class: Topical antibacterial and antifungal.
- Pharmacologic class: Topical anti-infectives.
Pharmacology
- Mechanism of action: Kill or inhibit bacteria (mupirocin, silver sulfadiazine) or fungi (azole and allylamine topicals) on the skin.
- Onset / peak / duration: Local effect over days.
- Half-life / therapeutic level: Minimal systemic absorption.
Clinical use
- Indications: Impetigo and MRSA decolonization (mupirocin), burn wound infection prevention (silver sulfadiazine), tinea and cutaneous candidiasis (antifungals).
- Usual dose, route, frequency: Apply topically two to three times daily.
- Maximum dose / adjustments: Silver sulfadiazine avoided near term and in newborns and sulfa allergy.
Safety
- Contraindications: Sulfa allergy and G6PD deficiency (silver sulfadiazine), hypersensitivity.
- Black box warning: None.
- Interactions: Minimal topically.
- Pregnancy / lactation: Avoid silver sulfadiazine near term.
- High-alert: No.
Adverse effects
- Common side effects: Local irritation, burning.
- Serious effects to report: Leukopenia (silver sulfadiazine), severe local reaction, spreading infection.
- Antidote / reversal: Discontinue.
Nursing process
- Assessment before administration: Wound or lesion appearance, allergies.
- Interventions during therapy: Clean the area before applying; use clean technique for burns.
- Monitor: Wound healing, signs of infection, CBC with large burn areas (silver sulfadiazine).
- Evaluation / expected outcome: Resolution of skin infection.
Patient teaching
- Patient teaching: Apply as directed; complete the course; report worsening.
- Notify provider if: Spreading redness, fever, no improvement.
- Administration tips: Clean skin first; wash hands.