Nafcillin

C. diff Risk

Medium

Oral Bioavailability

NA

Approximate Cost

Dosing

Skin and soft tissue infections
2 gm IV every 4-6 hr

Endocarditis/catheter-related bloodstream infections
2 gm IV every 4 hr

General Information

Common Usage

Treatment of MSSA infections

Drug Monitoring

Lab

  • Baseline and periodic CBC with differential

  • periodic urinalysis/CMP

*Clinical

  • Hypersensitivity

  • Drug interactions (warfarin)

  • GI effects/diarrhea

Adverse Effects

  • Phlebitis at injection site

  • C. difficile diarrhea

  • Abnormal liver enzymes

  • Neutropenia

Major Interactions

  • Nafcillin is a CYP3A4 inducer and decreases serum concentrations of CYP3A4 substrates

  • Warfarin (decreased PT/INR)

  • Cyclosporine (decreases serum concentrations)

Pharmacology

Antimicrobial class: Antistaphylococcal penicillin

Pregnancy category: B

Average serum half life: 0.5-1 hr

Lung penetration: Therapeutic

Urine penetration: Therapeutic

Route of Elimination: primarily hepatic