In a prospective, randomized study of 34 patients with thermal burns, treatment with the topical agent Cerium nitrate-silver sulfadiazine was compared with therapy with silver sulfadiazine alone. Despite randomization, there was a significant difference in mean burn size, being larger in the silver sulfadiazine group. There was no significant difference between the two groups in clinical course, mortality, septic deaths, or quantitative microbiology of the burn wound. It is concluded that from these preliminary data no clearcut superiority for one cream over the other can be demonstrated at this time.