Nafcillin

C. diff Risk

Medium

Oral Bioavailability

NA

Spectrum Of Activity

Dosing

MeningitisSerious Infection25 mg/kg/dose IV every 8 hours. On day of life 8: change to 38 mg/kg/dose IV every 6 hours25 mg/kg/dose IV every 8 hours. On day of life 8: change to 25 mg/kg/dose IV every 6 hours

MeningitisSerious Infection38 mg/kg/dose IV every 6 hr. On day of life 29: change to 50 mg/kg/dose IV every 6 hr25 mg/kg/dose IV every 6 hr. On day of life 29: change to 50 mg/kg/does IV every 6 hr

Meningitis or Serious Infection50 mg/kg/dose IV every 6 hr
(max 3 grams/dose)

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

  • Phlebitis at injection site

  • C. difficile diarrhea

  • Abnormal liver enzymes

  • Neutropenia

Treatment of MSSA infections

Lab

  • Baseline and periodic CBC with differential

  • periodic urinalysis/CMP

*Clinical

  • Hypersensitivity

  • Drug interactions (warfarin)

  • GI effects/diarrhea

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

  • Warfarin (decreased PT/INR)

  • Cyclosporine (decreases serum concentrations)

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