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Hypokalemia Associated With Nafcillin Treatment

Qua, Debbie Anne C. MD; Tan, Michael J. MD

Infectious Diseases in Clinical Practice: March 2009 - Volume 17 - Issue 2 - p 130-131
doi: 10.1097/IPC.0b013e318184d7a2
Case Reports

Nafcillin is a semisynthetic penicillin extensively used for treatment of infections caused by penicillinase-producing staphylococci. It has been known to cause adverse reactions such as hypersensitivity reactions, rash, and phlebitis. However, there are only a few reports that describe nafcillin as a possible cause of hypokalemia (JAMA. 1979;242:544, J Pediatr. 1980; 97:841-842). It is thought to be largely due to nafcillin acting as an impermeant, nonreabsorbable anion, increasing potassium excretion. This report describes a patient treated with nafcillin for methicillin-susceptible Staphylococcus aureus psoas abscess who developed hypokalemia with apparent renal potassium wasting.

From the Department of Internal Medicine, Summa Health System, Akron, OH.

Reprints: Debbie Anne C. Qua, MD, Department of Internal Medicine, Summa Health System, 55 Arch Street, Suite 1A, Akron, OH 44304. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.