Nafcillin

Nafcillin

Nafcillin
Systematic (IUPAC) name
(2S,5R,6R)-6-[(2-ethoxy-1-naphthoyl)amino]-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-carboxylic acid
Clinical data
AHFS/Drugs.com
MedlinePlus
Pregnancy
category
  • US: B (No risk in non-human studies)
Legal status
  • (Prescription only)
Routes of
administration
IM, IV
Pharmacokinetic data
Protein binding 90%
Metabolism <30% hepatic
Biological half-life 0.5 hours
Excretion Biliary and renal
Identifiers
CAS Registry Number  Y
ATC code J01
PubChem CID:
DrugBank  Y
ChemSpider  Y
UNII  Y
ChEBI  Y
ChEMBL  Y
Chemical data
Formula C21H22N2O5S
Molecular mass 414.476 g/mol
 Y   

Nafcillin sodium is a narrow-spectrum[1] beta-lactam antibiotic[2] of the penicillin class. As a beta-lactamase-resistant penicillin, it is used to treat infections caused by Gram-positive bacteria, in particular, species of staphylococci that are resistant to other penicillins.

Nafcillin is considered therapeutically equivalent to oxacillin, although its safety profile is somewhat different.[3]

Contents

  • Indications 1
  • Side-effects 2
  • Interactions 3
  • References 4

Indications

Nafcillin is indicated in the treatment of staphylococcal infections, except those caused by MRSA.[3]

U.S. clinical practice guidelines recommend either nafcillin or oxacillin as the first-line treatment of choice for staphylococcal endocarditis in patients without artificial heart valves.[4]

Side-effects

As with all penicillins, serious life-threatening allergic reactions can occur.

Milder side-effects include:

Interactions

There is evidence that it induces cytochrome P-450 enzymes specifically CYP2C9.[6]

The other aspect of this medication is that this medication contains lots of salts as media. So it could cause some edema or fluid accumulation. It would be prudent to avoid this medication if there were a concern for a congestive heart failure or kidney disease.

References

  1. ^ Palmer DL, Pett SB, Akl BF (March 1995). "Bacterial wound colonization after broad-spectrum versus narrow-spectrum antibiotics". Ann. Thorac. Surg. 59 (3): 626–31.  
  2. ^ Tan AK, Fink AL (January 1992). "Identification of the site of covalent attachment of nafcillin, a reversible suicide inhibitor of beta-lactamase". Biochem. J. 281 (1): 191–6.  
  3. ^ a b Pham P, Bartlett JG (January 2, 2009). "Nafcillin". Point-of-Care Information Technology ABX Guide.   Retrieved on July 10, 2009. Freely available with registration.
  4. ^ Bonow RO, Carabello BA, Kanu C, et al. (August 2006). "ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons". Circulation 114 (5): e84–231.  
  5. ^ JA Mohr. (1979). Nafcillin-associated hypokalemia. JAMA
  6. ^ Lang CC, Jamal SK, Mohamed Z, Mustafa MR, Mustafa AM, Lee TC (June 2003). "Evidence of an interaction between nifedipine and nafcillin in humans". Br J Clin Pharmacol 55 (6): 588–90.