Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027947 (neutropenia)
 17,527 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nafcillin (150 mg/kg/day, divided every six hours) was administered intravenously to 46 patients ranging from 5 to 163 months of age with suspected or proved bacterial infections. Thirteen of 15 patients with bacteriologically proved infection responded to nafcillin. Two patients with cellulitis due to Escherichia coli or to Hemophilus influenzae type b did not improve with nafcillin therapy. A mean serum nafcillin concentration of 48 microgram/ml was observed 30 minutes after a dose of 37.5 mg/kg. The mean serum half-life was 0.76 hours. There was no significant relation between age and serum half-life, volume of distribution, or plasma clearance rate. Two patients developed neutropenia and six other patients developed an eosinophilia greater than 400/mm3 while receiving nafcillin. No significant toxic effect of nafcillin on liver or renal function was observed. One patient had phlebitis. There was a significant correlation between nfacillin concentrations and serum inhibitory and bactericidal titers (P less than 0.001). Results from this study indicate that nafcillin is a safe and effective antibiotic for the treatment of infections due to susceptible bacteria in the dosage tested.
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PMID:Clinical and pharmacokinetic evaluation of nafcillin in infants and children. 72 20

Two cases of nafcillin-induced neutropenia in children are discussed. A seven-year-old girl was referred to the hospital after the pain and swelling in her foot persisted despite five days of oral penicillin VK therapy. Administration of intravenous nafcillin 150 mg/kg/day was started upon admission. The patient's leukocyte count was normal upon admission; further, her leukocyte and neutrophil counts were normal on the 10th and 17th days of hospitalization. After 22 days of nafcillin therapy, her leukocyte and neutrophil counts fell to 2300 and 162/cu mm, respectively. Three days after the nafcillin was discontinued, the leukocyte count was 5800/cu mm. The patient was given dicloxacillin 50 mg/kg/day, and had no recurrence of neutropenia. The second case involved a 28-month-old girl admitted to the hospital with fever, irritability, and skin rash. Her leukocyte count was normal upon admission. She received 10 days of penicillin G 100,000 units/kg/day, followed by 10 days of nafcillin 150 mg/kg/day, before neutropenia was discovered. On the ninth day of nafcillin therapy, here leukocyte and neutrophil counts were 4200 and 822/cu mm, respectively. Nafcillin was discontinued and cefazolin therapy was initiated at 100 mg/kg/day. Blood counts returned to normal, and there was no recurrence of neutropenia. Differential blood cell counts should be performed on patients receiving nafcillin, and, if neutropenia develops, nafcillin should be discontinued and treatment with a nonpenicillin antimicrobial considered.
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PMID:Nafcillin-induced neutropenia in two children. 724 66

Nafcillin is an antibiotic used for infections due to penicillin-resistant Staphylococcus aureus. In general, the adverse reactions to nafcillin have not been frequent and serious. We report here a new type of adverse reaction to nafcillin in a patient with end-stage renal disease in whom nafcillin caused the unexpected complication of bullous drug eruption and subseqent neutropenia. Three weeks after the start of intravenous nafcillin for the treatment of peritoneal dialysis peritonitis, the patient developed blisters on his right ankle. These became progressive and widespread, with bullae affecting most of the body surface. In addition, neutropenia developed three days after the appearance of bullous skin lesions. Spontaneous recovery of skin lesions and neutropenia was observed after the withdrawal of naficillin. When treating patients with chronic renal failure, physicians should be aware of these rare but potentially severe adverse reactions.
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PMID:Nafcillin-induced bullous skin eruption with granulocytopenia in a patient with end-stage renal disease. 2229 4

Background: Nafcillin or cefazolin are drugs of choice for methicillin-susceptible Staphylococcus aureus (MSSA) infections. Prior studies indicate a higher incidence of acute kidney injury (AKI) with nafcillin, although AKI classification and time to occurrence is not well described. Objective: To characterize the incidence and time to adverse drug events for nafcillin versus cefazolin in the inpatient setting. Methods: A retrospective cohort study evaluated hospitalized, adult patients receiving intravenous nafcillin or cefazolin for treatment of MSSA infection. Incidence and time to AKI based on RIFLE criteria were measured. Secondary end points included antibiotic discontinuation and incidence of neutropenia, thrombocytopenia, elevated transaminases, and Clostridioides difficile infection (CDI). Results: Of 324 patients who received nafcillin (n = 119) or cefazolin (n = 205), higher rates of AKI were found for nafcillin versus cefazolin (19% vs 2%, respectively; P < 0.0001). Median time to AKI with nafcillin was 6.5 days (range, 3-14 days). The majority of patients were classified as RIFLE "Risk" stratum. Nafcillin treatment discontinuations were more frequent than for cefazolin (17.6% vs 0.9%, respectively; P < 0.0001). Nafcillin was an independent predictor of AKI (odds ratio = 12.4; 95% CI = 4.14-47.60, P < 0.0001). No differences in neutropenia, thrombocytopenia, elevated transaminases, or CDI were observed. Conclusion and Relevance: Nafcillin displayed higher rates of AKI at a median of 1 week of therapy, which provides a framework for clinician monitoring and consideration of antibiotic modification. Most patients developed "Risk" class AKI (RIFLE classification), which may be reversible with prompt intervention.
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PMID:Retrospective Analysis of Adverse Drug Events Between Nafcillin Versus Cefazolin for Treatment of Methicillin-Susceptible Staphylococcus aureus Infections. 3188 47