Nafcillin

Activity represents that of both oxacillin and nafcillin. 

The pharmacology of penicillins differs markedly from compound to compound but has been well reviewed (57). The majority of derivatives, including penicillin G and the antipseudomonal penicillins, ate unstable in gastric acid and ate not available orally. The isoxazolyl penicillins ate relatively acid stable but not consistendy well absorbed by the oral route. Nafcillin and oxacillin ate poody absorbed orally cloxacillin, dicloxacillin, and ducloxacillin ate more teUable. Penicillin V, ampicillin, and patticulady amoxicillin ate relatively well absorbed orally. Esters of ampicillin such as bacampicillin, pivampicillin, and talampicillin improve the level of oral absorption of ampicillin to that achieved by amoxicillin. Absorption can be diminished by food after oral adruinistration, however, and peak blood levels, usually achieved after 1 to 2 h, ate somewhat delayed after ingestion of food. 

Acylation of 6-APA by the naphthoic acid, 13, again affords an agent with considerable steric hindrance about the amide function. There is thus obtained the antibiotic nafcillin (14). a compound with good resistance to penicillinases. 

Epicillln Floxaclllin Methicillin sodium Nafcillin sodium Oxacillin sodium Penicillin V... 

Ethoxy-1 -naphthoyl chloride Nafcillin sodium 2-Ethoxyphenol... 

C22H40O3 114162-01-5) see Betacarotene 2-ethoxy-l-naphthoyl chloride (C,3HiiClO 55750-29-i) see Nafcillin... 

Amiodarone, ampicillin, amoxicillin, captopril, chlorpro-mazine, ceftriaxone, erythromycin estolate, estrogen products, methimazole, nafcillin, rifampin, sulfonamide antimicrobials, and sulfonylureas... 

Penicillin, ampicillin, nafcillin, ticarcillin, aminoglycosides, and amphotericin B... 

JB, a 44-year-old man, is admitted to the hospital for treatment of a cellulitis. He states that he has no known allergies. JB is prescribed intravenous nafcillin for his infection. During the first infusion, he notices that his ears are itching, and he calls for a health care practitioner. On the practitioner s arrival, JB appears nervous and is having difficulty breathing. 

Nafci 11 i n/oxaci 11 f n 75 mg/kg IV per day in divided doses every 8-12 hours Nafcillin 100-150 mg/kg IV per day in divided doses every 6-8 hours Oxacillin 150-200 mg/kg IV per day in divided doses every 6-8 hours 200 mg/kg IV per day in divided doses every 6 hours max, 2 gm pediatrics greater than 3 months of age... 

It is important to determine (1) whether the isolate is methicillin-susceptible or methicillin-resistant and (2) whether the patient has a prosthetic valve. For patients with no prosthetic material, methicillin-susceptible staphylococci treatment should consist of a penicillinase-resistant penicillin (e.g., nafcillin or oxacillin) with or without gentamicin, and for methicillin-resistant strains, therapy should consist of vancomycin (see Table 71-4). Combination therapy with aminoglycosides, when used in these patients, typically is given only during the first 3 to 5 days of therapy. In the absence of prosthetic material, some treatment guidelines do not recommend combination therapy against MRSA. However, many clinicians may combine either gentamicin or rifampin with vancomycin if the patient is unresponsive to monotherapy. 

Nafcillin or oxacillin 12 g/24 hours IV in 4-6 equally divided doses 6 IA For complicated right-sided IE and for left-sided IE, 6-week treatment for uncomplicated rightsided IE, 2-week treatment... 

Penicillin C 24 million units/24 hours IV in 4 to 6 equally divided doses may be used in place of nafcillin or oxacillin if strain is penicillin-susceptible (minimum inhibitory concentration less than or equal to 0.1 mcg/mL) and does not produce P-lactamase. cGentamicin should be administered in close temporal proximity to vancomycin, nafcillin, or oxacillin dosing. 

Pediatric dosec nafcillin Table 71-3 for dosing guidelines) ... 

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