Usual Adult Dose for Bacterial Infection

Topical Cream: Apply with a sterile gloved hand to cleansed and debrided burn wounds once or twice a day, to a thickness of about 1/16 inch

Topical Solution: Grafted area should be covered with 1 layer of fine mesh gauze; an 8-ply burn dressing (cut to size of graft) should be wetted with this solution using an irrigation syringe and/or irrigation tubing until leaking noticeable; gauze dressing should be kept wet by:

• Irrigating with a syringe or injecting solution into irrigation tubing every 4 hours or as needed OR
• If irrigation tubing not used, by moistening gauze dressing every 6 to 8 hours or as needed to keep wet

• Topical cream: Application thicker than 1/16 inch is not recommended.
• Topical cream: The cream should be reapplied whenever it is removed from any area (e.g., by patient activity) to always keep burned areas covered with this drug.
• Topical cream: Dressings are not usually necessary; however, if the patient requires them, only a thin layer of dressings should be used.
• Topical cream: Duration of therapy depends on patient requirements; treatment generally continued until healing is progressing well or until burn site is ready for grafting.
• Topical solution: If irrigation tubing used, it should be placed over the burn dressing in contact with the wound and covered with second piece of 8-ply dressing; irrigation dressing should be secured with a bolster dressing and wrapped as appropriate.
• Topical solution: May leave wound dressings undisturbed, except for irrigations, for up to 5 days; additional soaks may be started until graft take is complete.
• Topical solution: Maceration of skin may result from wet dressings applied for intervals as short as 24 hours.
• Topical solution: Treatment generally continued until autograft vascularization occurs and healing is progressing (usually in about 5 days); safety and efficacy not established for longer than 5 days for an individual grafting procedure.

• Topical cream: As adjunctive therapy of patients with second- and third- degree burns
• Topical solution: As an adjunctive topical antimicrobial agent to control bacterial infection when used under moist dressings over meshed autografts on excised burn wounds

Usual Adult Dose for Burns - External

Topical Cream: Apply with a sterile gloved hand to cleansed and debrided burn wounds once or twice a day, to a thickness of about 1/16 inch

Topical Solution: Grafted area should be covered with 1 layer of fine mesh gauze; an 8-ply burn dressing (cut to size of graft) should be wetted with this solution using an irrigation syringe and/or irrigation tubing until leaking noticeable; gauze dressing should be kept wet by:

• Irrigating with a syringe or injecting solution into irrigation tubing every 4 hours or as needed OR
• If irrigation tubing not used, by moistening gauze dressing every 6 to 8 hours or as needed to keep wet

• Topical cream: Application thicker than 1/16 inch is not recommended.
• Topical cream: The cream should be reapplied whenever it is removed from any area (e.g., by patient activity) to always keep burned areas covered with this drug.
• Topical cream: Dressings are not usually necessary; however, if the patient requires them, only a thin layer of dressings should be used.
• Topical cream: Duration of therapy depends on patient requirements; treatment generally continued until healing is progressing well or until burn site is ready for grafting.
• Topical solution: If irrigation tubing used, it should be placed over the burn dressing in contact with the wound and covered with second piece of 8-ply dressing; irrigation dressing should be secured with a bolster dressing and wrapped as appropriate.
• Topical solution: May leave wound dressings undisturbed, except for irrigations, for up to 5 days; additional soaks may be started until graft take is complete.
• Topical solution: Maceration of skin may result from wet dressings applied for intervals as short as 24 hours.
• Topical solution: Treatment generally continued until autograft vascularization occurs and healing is progressing (usually in about 5 days); safety and efficacy not established for longer than 5 days for an individual grafting procedure.

• Topical cream: As adjunctive therapy of patients with second- and third- degree burns
• Topical solution: As an adjunctive topical antimicrobial agent to control bacterial infection when used under moist dressings over meshed autografts on excised burn wounds

Usual Pediatric Dose for Bacterial Infection

Topical Cream: Apply with a sterile gloved hand to cleansed and debrided burn wounds once or twice a day, to a thickness of about 1/16 inch

Topical Solution:
3 months or older: Grafted area should be covered with 1 layer of fine mesh gauze; an 8-ply burn dressing (cut to size of graft) should be wetted with this solution using an irrigation syringe and/or irrigation tubing until leaking noticeable; gauze dressing should be kept wet by:

• Irrigating with a syringe or injecting solution into irrigation tubing every 4 hours or as needed OR
• If irrigation tubing not used, by moistening gauze dressing every 6 to 8 hours or as needed to keep wet

• Topical cream: Application thicker than 1/16 inch is not recommended.
• Topical cream: The cream should be reapplied whenever it is removed from any area (e.g., by patient activity) to always keep burned areas covered with this drug.
• Topical cream: Dressings are not usually necessary; however, if the patient requires them, only a thin layer of dressings should be used.
• Topical cream: Duration of therapy depends on patient requirements; treatment generally continued until healing is progressing well or until burn site is ready for grafting.
• Topical solution: If irrigation tubing used, it should be placed over the burn dressing in contact with the wound and covered with second piece of 8-ply dressing; irrigation dressing should be secured with a bolster dressing and wrapped as appropriate.
• Topical solution: May leave wound dressings undisturbed, except for irrigations, for up to 5 days; additional soaks may be started until graft take is complete.
• Topical solution: Maceration of skin may result from wet dressings applied for intervals as short as 24 hours.
• Topical solution: Treatment generally continued until autograft vascularization occurs and healing is progressing (usually in about 5 days); safety and efficacy not established for longer than 5 days for an individual grafting procedure.

• Topical cream: As adjunctive therapy of patients with second- and third- degree burns
• Topical solution: As an adjunctive topical antimicrobial agent to control bacterial infection when used under moist dressings over meshed autografts on excised burn wounds

Usual Pediatric Dose for Burns - External

Topical Cream: Apply with a sterile gloved hand to cleansed and debrided burn wounds once or twice a day, to a thickness of about 1/16 inch

Topical Solution:
3 months or older: Grafted area should be covered with 1 layer of fine mesh gauze; an 8-ply burn dressing (cut to size of graft) should be wetted with this solution using an irrigation syringe and/or irrigation tubing until leaking noticeable; gauze dressing should be kept wet by:

• Irrigating with a syringe or injecting solution into irrigation tubing every 4 hours or as needed OR
• If irrigation tubing not used, by moistening gauze dressing every 6 to 8 hours or as needed to keep wet

• Topical cream: Application thicker than 1/16 inch is not recommended.
• Topical cream: The cream should be reapplied whenever it is removed from any area (e.g., by patient activity) to always keep burned areas covered with this drug.
• Topical cream: Dressings are not usually necessary; however, if the patient requires them, only a thin layer of dressings should be used.
• Topical cream: Duration of therapy depends on patient requirements; treatment generally continued until healing is progressing well or until burn site is ready for grafting.
• Topical solution: If irrigation tubing used, it should be placed over the burn dressing in contact with the wound and covered with second piece of 8-ply dressing; irrigation dressing should be secured with a bolster dressing and wrapped as appropriate.
• Topical solution: May leave wound dressings undisturbed, except for irrigations, for up to 5 days; additional soaks may be started until graft take is complete.
• Topical solution: Maceration of skin may result from wet dressings applied for intervals as short as 24 hours.
• Topical solution: Treatment generally continued until autograft vascularization occurs and healing is progressing (usually in about 5 days); safety and efficacy not established for longer than 5 days for an individual grafting procedure.

• Topical cream: As adjunctive therapy of patients with second- and third- degree burns
• Topical solution: As an adjunctive topical antimicrobial agent to control bacterial infection when used under moist dressings over meshed autografts on excised burn wounds

Renal Dose Adjustments

Acute renal failure: Caution recommended.

Liver Dose Adjustments

Data not available

Dose Adjustments

If acidosis occurs and becomes difficult to control, especially in those with pulmonary dysfunction, discontinuing therapy for 24 to 48 hours while continuing fluid therapy may help restore acid-base balance.

• Topical solution: Dressing changes and monitoring site for bacterial growth during interruption should be adjusted accordingly.

Precautions

CONTRAINDICATIONS:
Hypersensitivity to the active component

Topical Solution: Safety and efficacy have not been established in patients younger than 3 months.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• For topical use only
• Topical cream: Do not withdraw from therapeutic regimen while infection is possible.
• Topical solution: Once container is opened, discard unused solution after 48 hours.
• Consider stopping treatment if allergic manifestations occur.

• Topical cream: Avoid exposure to excessive heat (above 40C [104F]).
• Powder for topical solution: Store packets in a dry place at room temperature 15C to 30C (59F to 86F).
• Reconstituted topical solution: May be held up to 28 days after preparation if stored in unopened containers; once container is opened, use within 48 hours. Store at 20C to 25C (68F to 77F); limited storage periods at 15C to 30C (59F to 86F) acceptable.

• Topical solution: Empty entire contents of the premeasured 50 g packet into a suitable container containing 1000 mL of Sterile Water for Irrigation, USP or 0.9% Sodium Chloride Irrigation, USP; mix until completely dissolved.

• Topical cream: Promptly starting appropriate measures to control shock and pain is very important.
• Topical cream: When feasible, patients should be bathed daily to aid debridement; while a whirlpool bath is especially helpful, patients may be bathed in bed or in a shower.

• Dermatologic: Affected sites for bacterial growth when using the topical solution
• Metabolic: Acid-base balance