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Albert T. McManus, PhD; Camille L. Denton, MA; Arthur D. Mason, Jr, MD

Arch Surg. 1983;118(2):161-166.

Abstract
• Sulfonamide-resistant organisms have been reported as a frequent consequence of the clinical use of sulfadiazine silver. At this burn center, sulfonamide resistance occurred in more than 80% of gram-negative isolates. We tested the requirement for the individual antimicrobial activities of sulfadiazine and silver for in vitro activity of sulfadiazine silver. The sulfadiazine component is not necessary for in vitro sensitivity. In vitro sensitivity to sulfadiazine silver does not consistently predict the presence of therapeutic activity in Pseudomonas aeruginosa–infected rats with burns. We describe an example of a transferable multiple-antibiotic resistance plasmid that contains selectable sulfonamide resistance. The use of sulfadiazine silver can, therefore, lead to the selection of organisms that are resistant not only to sulfonamides but to antibiotics of clinical consequence, and this possible risk must be considered in electing to use the agent.

(Arch Surg 1983;118:161-166)

Author Affiliations
From the US Army Institute of Surgical Research, Fort Sam Houston, Tex.

Footnotes
Accepted for publication Oct 5, 1982.

Read before the second annual meeting of the Surgical Infection Society, Boston, April 19, 1982.

The views of the authors do not purport to reflect the positions of the Department of the Army or the Department of Defense.

Reprint requests to Library, US Army Institute of Surgical Research, Fort Sam Houston, TX 78234 (Dr McManus).

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