Clinical and pharmacokinetic evaluation of nafcillin in infants and children

Feldman, William E.; Nelson, John D.; Stanberry, Lawrence R.

doi:10.1016/s0022-3476(78)81251-7

Cited by 24 publications

(16 citation statements)

References 16 publications

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“…In comparison, the average peak blood level of infant rats in this study was 15.2 ,tg/ml (range, 12.3 to 21.0 ,tg/ml) after intraperitoneal injection of 3.125 mg/kg. The average reported peak blood level of nafcillin in children after intravenous administration of 37.5 mg/kg is 50 ,ug/ml (4). Such a blood level was attained in infant rats, with administrations of 50 mg/kg every 6 h. At such blood levels, neither ampicillin nor nafcillin alone effected sterilization of blood or CSF in the rat model.…”

Section: Discussionmentioning

confidence: 90%

Synergistic action of nafcillin and ampicillin against ampicillin-resistant Haemophilus influenzae type b bacteremia and meningitis in infant rats

Yogev¹,

Kabat²

1980

Antimicrob Agents Chemother

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Section: Discussionmentioning

confidence: 90%

Synergistic action of nafcillin and ampicillin against ampicillin-resistant Haemophilus influenzae type b bacteremia and meningitis in infant rats

Yogev¹,

Kabat²

1980

Antimicrob Agents Chemother

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“…In patients receiving nafcillin, 12-18 g/day for 6-67 days (average 28 days), Kancir et al [3] noted neutropenia in 3.4% leukopenia in 6.9%, and fever and/or rash in 10.3% of the population. In a pharmacokinetic study of nafcillin, 100-200 mg/kg/day, Feldman et al [10] observed eosinophilia in 20%, neutro penia in 6.7%, mild elevation of SGOT in 10%, and phlebitis at the infu sion site in 3.3 %. In our patients, the incidence of eosinophilia and elevated liver enzyme were considerably lower than reported values.…”

Section: Discussionmentioning

confidence: 99%

Adverse Effects of Methicillin, Nafcillin and Oxacillin in Pediatric Patients

Nahata¹,

DeBolt²,

Powell³

1982

Dev Pharmacol Ther

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68 patients (from newborns to 18 years of age) were studied prospectively for adverse effects associated with methicillin, nafcillin and oxacillin. Hematologic, liver and renal function tests were monitored before and during therapy. 3 of 28 patients receiving methicillin developed eosinophilia within 5-8 days. Of 32 patients on nafcillin, 2 had neutropenia within 4-13 days, 3 had eosinophilia within 1-4 days and 1 elevated liver enzymes on day 3. Of 8 patients receiving oxacillin, 1 developed neutropenia on day 11 and another showed elevation of liver enzymes on day 15. All abnormalities were reversible with the discontinuation of therapy. Appropriate laboratory tests should be monitored to detect an occurrence of adverse reaction to methicillin, nafcillin and oxacillin.

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“…The pharmacokinetic parameters in our patients cannot be compared because none of the available studies have re ported these data using a similar patient population and a specific analytical method to measure nafcillin. However, one study involving patients of various ages (5-163 months) and diagnoses in cluding cellulitis, septicemia, osteomyeli tis, pneumonia, meningitis, and/or ventri culitis reported a mean clearance of 0.49 to 0.70 l/min/1.73 m2, apparent distribu tion volume of 0.85 to 0.91 l/kg, and elimi nation half-life of 0.68 to 0.81 h; nafcillin was administered at a dose of 37.5 mg/kg every 6 h and measured in serum using a microbiological assay [8].…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics and Cerebrospinal Fluid Concentration of Nafcillin in Pediatric Patients Undergoing Cerebrospinal Fluid Shunt Placement

Nahata

Fan-Havard²,

Kosnik³

et al. 1990

Chemotherapy

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Postoperative infection is among the most common complications in patients with cerebrospinal fluid shunt placement. Nafcillin is often used for prophylaxis but no pharmacokinetic data are available perioperatively in pediatric patients. The objectives of this study were to characterize the pharmacokinetics and determine the cerebrospinal concentrations of nafcillin. Ten patients (mean age 8.0 ± 5.6 years) received three doses of intravenous nafcillin, 50 mg/kg every 6 h; the first dose was administered 1 h prior to surgery. Multiple blood samples were collected during and after surgery and the cerebrospinal fluid sample was obtained at the time of shunt insertion. Urine samples were collected for 24 h after initiation of nafcillin. Nafcillin was analyzed with an HLPC method. The peak serum concentrations ranged from 22 to 107 μg/ml; cerebrospinal fluid concentrations ranged from 0.02 to 0.30 (mean 0.16 ± 0.11) μg/ml. The mean total clearance, renal clearance, apparent volume of distribution, and elimination half-life were 0.90 ± 0.55 1/kg/h, 0.12 ± 0.04 1/kg/h, 0.70 ± 0.52 1/kg, and 0.5 ± 0.1 h, respectively. 16% of total nafcillin dose was excreted in the urine. A 4-fold variability in total clearance and a 10-fold variation in cerebrospinal fluid concentrations of nafcillin was observed in these patients. Further, the concentrations of nafcillin attained in the cerebrospinal do not appear to be adequate, based on its minimum inhibitory concentration of 0.5 μ.g/ml against very susceptible staphylococci. These data, in addition to the fact that an increasing number of staphylococci are becoming resistant to nafcillin, question the usefulness of prophylactic nafcillin in pediatric patients undergoing shunt procedures.

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Clinical and pharmacokinetic evaluation of nafcillin in infants and children

Cited by 24 publications

References 16 publications

Synergistic action of nafcillin and ampicillin against ampicillin-resistant Haemophilus influenzae type b bacteremia and meningitis in infant rats

Synergistic action of nafcillin and ampicillin against ampicillin-resistant Haemophilus influenzae type b bacteremia and meningitis in infant rats

Adverse Effects of Methicillin, Nafcillin and Oxacillin in Pediatric Patients

Pharmacokinetics and Cerebrospinal Fluid Concentration of Nafcillin in Pediatric Patients Undergoing Cerebrospinal Fluid Shunt Placement

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