ArticleAntimicrobial agents and chemotherapy2016
Adverse Events Lead to Drug Discontinuation More Commonly among Patients Who Receive Nafcillin than among Those Who Receive Oxacillin.
Article in Antimicrobial agents and chemotherapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Systematic Review and Meta-analysis of the Safety of Antistaphylococcal Penicillins Compared to Cefazolin.Antimicrobial agents and chemotherapy · 2018Pooled it
- Active surveillance and risk prediction of piperacillin/tazobactam‑associated hypokalaemia: development and external validation of a clinical nomogram.International journal of clinical pharmacy · 2026Article
- A pharmacist-led framework for antibiotic-associated liver injury: from pharmacovigilance signals to bedside surveillance with the updated RUCAM and susceptibility markers.Frontiers in pharmacology · 2026Review
- Comparison of Adverse Effect Profiles of Nafcillin and Oxacillin in Pediatric Patients.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2024Article
- Heartbreaking Decisions: The Dogma and Uncertainties of Antimicrobial Therapy in Infective Endocarditis.Pathogens (Basel, Switzerland) · 2023Review
- Electrolyte Disorders Associated with Piperacillin/Tazobactam: A Pharmacovigilance Study Using the FAERS Database.Antibiotics (Basel, Switzerland) · 2023Article
- Frequency of drug-induced liver injury in children receiving anti-staphylococcal penicillins.The Journal of antimicrobial chemotherapy · 2022Review
- Combination with a FtsZ inhibitor potentiates the in vivo efficacy of oxacillin against methicillin-resistantMedicinal chemistry research : an international journal for rapid communications on design and mechanisms of action of biologically active agents · 2022Article
- Incidence and Determinants of Piperacillin/Tazobactam-Associated Hypokalemia: A Retrospective Study.Antibiotics (Basel, Switzerland) · 2022Article
- Disproportionality Analysis of Safety with Nafcillin and Oxacillin with the FDA Adverse Event Reporting System (FAERS).Antimicrobial agents and chemotherapy · 2020Article
- Comparative Effectiveness of Exclusive Exposure to Nafcillin or Oxacillin, Cefazolin, Piperacillin/Tazobactam, and Fluoroquinolones Among a National Cohort of Veterans With Methicillin-SusceptibleOpen forum infectious diseases · 2019Article
- A Case of Hypokalemia Possibly Induced by Nafcillin.Antibiotics (Basel, Switzerland) · 2018Article
- Drug-Induced Kidney Injury in the Elderly.Drugs & aging · 2017Review
- The Safety and Economic Impact of Cefazolin versus Nafcillin for the Treatment of Methicillin-Susceptible Staphylococcus aureus Bloodstream Infections.Infectious diseases and therapy · 2017Article
- Risk Factors Associated With Outpatient Parenteral Antibiotic Therapy Program Failure Among Intravenous Drug Users.Open forum infectious diseases · 2017Article
- A Patient with Nafcillin-Associated Drug-Induced Liver Failure.Case reports in gastroenterologyArticle
- A review of evidence, antimicrobial stability, and feasibility considerations for OPAT continuous infusion.Therapeutic advances in infectious diseaseReview
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
Nafcillin and oxacillin are used interchangeably in clinical practice, yet few studies have evaluated the safety of these two agents. Our objective was to compare the differential tolerabilities of nafcillin and oxacillin among hospitalized patients. We conducted a retrospective cohort study of all patients who received 12 g/day of nafcillin or oxacillin for at least 24 h. Two hundred twenty-four patients were included. Baseline characteristics and comorbidities were similar among patients receiving nafcillin (n = 160) and those receiving oxacillin (n = 64). Hypokalemia, defined as a potassium level of ≤3.3 mmol/liter or ≤2.9 mmol/liter or as a ≥0.5-mmol/liter decrease from the baseline level, occurred more frequently among patients who received nafcillin (51%, 20%, and 56%, respectively) than among those who received oxacillin (17%, 3%, and 34%, respectively; P < 0.0001, P = 0.0008, and P = 0.005, respectively). By multivariate logistic regression analysis, receipt of nafcillin was an independent predictor of severe hypokalemia (odds ratio [OR] = 6.74; 95% confidence interval [CI], 1.46 to 31.2; P = 0.02). Rates of hepatotoxicity did not differ between groups; however, acute kidney injury occurred more commonly with nafcillin than with oxacillin (18% versus 6%; P = 0.03). Overall, 18% of patients who received nafcillin discontinued therapy prematurely due to adverse events, compared to 2% of patients who received oxacillin (P = 0.0004). Nafcillin treatment is associated with higher rates of adverse events and treatment discontinuation than oxacillin among hospitalized adult patients. These findings have important implications for patients in both inpatient and outpatient settings, particularly patients who require long-term therapy and cannot be monitored routinely. Future randomized controlled studies evaluating the efficacy, costs, and tolerability of nafcillin versus oxacillin are warranted.
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