Comparative Pharmacology
Head-to-head clinical analysis: NAFCILLIN SODIUM versus PIPERACILLIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NAFCILLIN SODIUM versus PIPERACILLIN.
NAFCILLIN SODIUM vs PIPERACILLIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Nafcillin exerts bactericidal activity by inhibiting bacterial cell wall synthesis via binding to penicillin-binding proteins (PBPs), thereby disrupting peptidoglycan cross-linking. It is resistant to staphylococcal beta-lactamases.
Inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), inhibiting transpeptidation, and activating autolytic enzymes.
1-2 g IV every 4 hours; or 1-2 g IM every 4-6 hours.
3.375 g IV every 6 hours (piperacillin-tazobactam); for piperacillin alone, 3 g IV every 6 hours.
None Documented
None Documented
Approximately 0.5 hour (30 minutes) in adults with normal renal function; prolonged to 1-2 hours in neonates or severe renal impairment. Clinically relevant for dosing every 4-6 hours.
Clinical Note
moderatePiperacillin + Probenecid
"The serum concentration of Probenecid can be increased when it is combined with Piperacillin."
Clinical Note
moderatePiperacillin + Mycophenolic acid
"The serum concentration of the active metabolites of Mycophenolic acid can be reduced when Mycophenolic acid is used in combination with Piperacillin resulting in a loss in efficacy."
Clinical Note
moderatePiperacillin + Plicamycin
"The serum concentration of Plicamycin can be decreased when it is combined with Piperacillin."
Clinical Note
moderate0.6-1.2 hours in adults with normal renal function; prolonged to 2-6 hours in renal impairment (CrCl <20 mL/min); requires dose adjustment in renal failure
Primarily renal (30-40% unchanged) and hepatic/biliary elimination. Approximately 10-15% excreted in bile via feces.
Renal: approximately 70-90% unchanged via glomerular filtration and tubular secretion; biliary: 10-20% excreted unchanged in bile; fecal: minor (<5%)
Category A/B
Category C
Penicillin Antibiotic
Penicillin Antibiotic
Piperacillin + Valrubicin
"The serum concentration of Valrubicin can be decreased when it is combined with Piperacillin."