MEDICATIONS - Medicine for Mountaineering and Other Wilderness Activities - page 522

Silver Sulfadiazine Cream
Silver sulfadiazine cream is a sulfonamide in an ointment (Silvadene®, SSD Cream®,
and others) that is applied to burns to help control bacterial infections ( Chapter 13: Burns ) .
It is effective against a wide variety of organisms, particularly the organisms that most
commonly infect burns.
Precautions: Since silver sulfadiazine is a sulfonamide, the precautions described for
TMP-SMX should be observed.
Application: A thin layer of the cream should be applied sterilely to the burn twice a
day if the burn is exposed. Dressings covering a burn should not be removed just to apply
the cream if no evidence of infection is present.
Metronidazole
Metronidazole (Flagyl® and others) is a drug used to treat a variety of parasitic infest-
ations and bacterial infections. Its principal use in wilderness circumstances would be for
treating Giardiasis and amebiasis, but this drug is also used to treat Clostridium difficile
colitis ( Chapter 19: Gastrointestinal Disorders ) .
Precautions: Alcoholic beverages taken during therapy with metronidazole can cause
severe vomiting and should be avoided while the drug is being taken and for one day after-
ward.
Metronidazole should be administered only by a physician during the first trimester of
pregnancy and to anyone with concomitant disease, particularly liver, blood, or neurologic
disorders.
Metronidazole should not be given to children except to treat amebiasis.
Tinidazole
Tinidazole (Tindamax® or Tiniba®) is an antiparasitic drug used widely throughout
Europe and the developing world as treatment for a variety of parasitic infections. It is
chemically similar to metronidazole but has a shorter treatment course with a more con-
venient dosage schedule.
Precautions: The precautions for tinidazole are the same as those for metronidazole.
ANTIFUNGAL AGENTS
Clotrimazole Cream
Clotrimazole is a broad-spectrum antifungal agent that is applied for skin infections,
particularly tinea pedis (athlete's foot), tinea cruris (jock itch), and ringworm caused by
various species of fungi and yeasts.
Precautions: Clotrimazole is poorly absorbed through the skin, and toxic reactions are
uncommon.