Spectrum: Local Antimicrobial Stewardship, for Bakersfield Memorial Hospital

Nafcillin

C. diff Risk

Medium

Oral Bioavailability

NA

Approximate Cost

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

Dosing

Adult

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

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

Pediatric

General Information

Common Usage

Common Usage

Treatment of MSSA infections

Drug Monitoring

Drug Monitoring

Lab

  • Baseline and periodic CBC with differential

  • periodic urinalysis/CMP

*Clinical

  • Hypersensitivity

  • Drug interactions (warfarin)

  • GI effects/diarrhea

Adverse Effects

Adverse Effects

  • Phlebitis at injection site

  • C. difficile diarrhea

  • Abnormal liver enzymes

  • Neutropenia

Major Interactions

Major Interactions

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

  • Warfarin (decreased PT/INR)

  • Cyclosporine (decreases serum concentrations)

Pharmacology

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