Nafcillin Injection, USP is a sterile injectable product containing nafcillin which is added as Nafcillin Sodium, USP, a semisynthetic penicillin derived from the penicillin nucleus, 6-aminopenicillanic acid. The chemical name of nafcillin sodium is Monosodium (2 S,5 R,6 R)-6-(2-ethoxy-1-naphthamido)-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2. 0]heptane-2-carboxylate monohydrate. It is resistant to inactivation by the enzyme penicillinase (beta-lactamase).
Nafcillin is indicated in the treatment of infections caused by penicillinase-producing staphylococci which have demonstrated susceptibility to the drug. Culture and susceptibility tests should be performed initially to determine the causative organism and its susceptibility to the drug (see CLINICAL PHARMACOLOGY - Susceptibility Tests).
Nafcillin may be used to initiate therapy in suspected cases of resistant staphylococcal infections prior to the availability of susceptibility test results. Nafcillin should not be used in infections caused by organisms susceptible to penicillin G. If the susceptibility tests indicate that the infection is due to an organism other than a resistant Staphylococcus, therapy should not be continued with Nafcillin Injection, USP.
To reduce the development of drug-resistant bacteria and maintain the effectiveness of Nafcillin Injection, USP and other antibacterial drugs, Nafcillin Injection, USP should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.
Published Studies Related to Nafcillin
Evidence of an interaction between nifedipine and nafcillin in humans. [2003.06]
AIMS: Nafcillin (Wyeth Laboratories, Philadelphia, PA, USA) has been reported to induce the metabolism of cyclosporin and warfarin, which are known substrates of cytochrome P-450 (CYP). However, there has not been any report to date on its possible interaction with nifedipine, an index substrate of the enzyme, CYP3A4... CONCLUSIONS: The results show that nafcillin pretreatment markedly increased the clearance of nifedipine and suggest that nafcillin is a potent inducer of CYP enzyme.
Randomized, double-blind trial of cefonicid and nafcillin in the treatment of skin and skin structure infections. [1990.04]
We compared treatment with one daily intravenous dose of cefonicid and multidose nafcillin in 65 patients with severe infections of the skin or skin structure. Clinical cure or improvement was achieved in 91% of the patients given cefonicid and in 87% of the patients given nafcillin (P = 0.97).The use of cefonicid may allow outpatient therapy of some severe infections.
Clinical Trials Related to Nafcillin
Study of Daptomycin in Subjects Undergoing Surgery for Osteomyelitis Associated With an Infected Prosthetic Caused by Staphylococci [Recruiting]
Safety and Efficacy of CEM-102 With Rifampin Compared to Standard Intravenous Therapy in Patients With Prosthetic Joint Infections [Recruiting]
To determine if oral antibiotic treatment with CEM-102 and Rifampin is as effective and safe
as the standard of care intravenous antibiotic therapy for the treatment of infected hip and
knee joints after joint replacement surgery.
Patients Response to Early Switch To Oral:Osteomyelitis Study [Not yet recruiting]
Based on the current literature, investigators hypothesize that patients with osteomyelitis
who are treated with the standard approach of intravenous antibiotics for the full duration
of therapy will have the same clinical outcomes as patients treated with the experimental
approach of intravenous antibiotics with early switch to oral antibiotics.
The primary objective of this study is to compare patients with osteomyelitis treated with
the standard approach of intravenous antibiotics for the full duration of therapy versus
patients treated with intravenous antibiotics with an early switch to oral antibiotics in
relation to clinical outcomes at 12 months after discontinuation of antibiotic therapy.
Secondary objectives of the study include the evaluation of adverse events related to the
use of antibiotics as well as the cost of care evaluated from the hospital perspective.
Treatment Algorithm to Reduce the Use of Vancomycin in Adults With Blood Stream Infection [Recruiting]
A Phase 3 Telavancin Staph Aureus Bacteremia Trial [Recruiting]
This is a multicenter, randomized, open-label, noninferiority trial of telavancin versus
standard IV therapy (e. g., vancomycin, daptomycin, anti-staphylococcal penicillin (PCN), or
cefazolin) control in the treatment of subjects with complicated Staphylococcus. aureus (SA)
bacteremia and SA right-sided infective endocarditis (RIE).
Reports of Suspected Nafcillin Side Effects
Abdominal Distension (7),
Renal Failure Acute (5),
Atrial Flutter (5),
Renal Failure (5),
Pulmonary Hypertension (4), more >>
Page last updated: 2007-05-03