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Nafcillin/Uniipen


- See Penicillin Family

- For penicillinase producing Staph;
- Adult: 50-200 mg/kg/24hr;
         IV: 500 mg - 1gm q4h for severe infections;
         IM: 500 mg q4-6hr for severe infections;
         PO: 250 - 500mg q4-6hr
- Peds: 100-200 mg/kg/day q6hr;
- Poorly absorbed orally, cloxacillin or dicloxacillin better for PO use;
- Note: Ratio of CSF to Blood Level (%): Normal Meninges: trace in 1/2 of pts.; Inflammed Meninges: 9-20;

- Cautions:
    - can cause pain at IV site, and if subQ infiltration occurs, serious skin sloughing may result;
    - Requires Dose Reduction in Hepatic Dysfunction;
    - Will interact with aminoglycosides;
    - Dosing Regimens for Patients w/ Renal Insufficiency:
           (Dose for70kgAdult {gm/dosing interval in hours}):
           CrCl: >80: 1/4-6; CrCl: 50-79: 1/4-6; CrCl:30-49: 1/4-6; CrCl:10-29: 1/4-6
           - 10% of drug will be excreted in to urine (w/ nl RF(x))


Cefotaxime vs nafcillin and tobramycin for the treatment of serious infection. Comparative cost-effectiveness.