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Nafcillin

A narrow-spectrum beta-lactam antibiotic of the penicillin class.

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.

Pregnancy category US:

Routes of administration IM, IV

Protein binding 90%

Metabolism less than 30% hepatic.

Elimination half-life 0.5 hours

Excretion-Biliary and renal

Considered therapeutically equivalent to oxacillin

Indicated in the treatment of staphylococcal infections, except those caused by MRSA.

Guidelines recommend either nafcillin or oxacillin as the first-line treatment of choice for staphylococcal endocarditis in patients without artificial heart valves.

Life-threatening allergic reactions can occur.

Milder side-effects include: Hypokalemia

Nausea and vomiting

Diarrhea

Abdominal pain

Yeast infections

Agranulocytosis, neutropenia

It induces cytochrome P-450 enzymes specifically CYP2C9, and warfarin and nifedipine, are metabolized by CYP2C9.

Nafcillin contains salts and should be avoided in patients with congestive heart failure or kidney disease.

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