Unfortunately, burn centers are now reporting sulfadiazine resistance. Important toxicities associated with the use of silver sulfadiazine include hypersensitivity reactions to sulfa, transient leukopenia, and formation of pseudoeschar.
Silver nitrate is a bacteriostatic agent to which bacterial resistance is rare.
Use of silver nitrate as a continuous wet soak minimizes evaporative skin loss. Contact with the eyes must be avoided. A brown discoloration to all skin surfaces occurs on contact due to precipitation of silver salts. Although the medication itself is inexpensive, the dressings must be reinforced with silver nitrate frequently. The major complications associated with the use of silver nitrate are electrolyte disturbances.