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Cephalexin

    Brands

    DEA Class; Rx

    Common Brand Names; Keflex, Panixine Disperdose

    • Cephalosporins, 1st Generation

    Oral, first-generation cephalosporin used primarily for otitis media and infections of the respiratory tract due to susceptible staphylococci, Streptococcus pneumoniae, and group A beta-hemolytic streptococci.

    Indicated for the treatment of upper respiratory tract infections, including group A beta-hemolytic streptococcal (GAS) pharyngitis (primary rheumatic fever prophylaxis) and tonsillitis.

    For the treatment of lower respiratory tract infections (LRTIs), including community-acquired pneumonia (CAP).
    For the treatment of otitis media.
    For the treatment of bone and joint infections (i.e., osteomyelitis, infectious arthritis).
    For the treatment of genitourinary infection (i.e., urinary tract infection (UTI), cystitis, prostatitis).
    For the treatment of mastitis.
    For the treatment of skin and skin structure infections, including impetigo, cellulitis, erysipelas, skin abscesses, furunculosis, carbuncle, diabetic foot ulcer, and surgical incision site infections.
    For urinary tract infection (UTI) prophylaxis.

    Documented hypersensitivity

    • Abdominal pain
    • Agitation
    • Anemia
    • Angioedema
    • Confusion
    • Diarrhea
    • Dizziness
    • Dyspepsia
    • Elevated transaminases
    • Eosinophilia hemolytic
    • Epidermal necrolysis
    • Erythema multiform
    • Fatigue
    • Gastritis
    • Genital pruritus
    • Hallucinations
    • Headache
    • Hemolytic anemia
    • Hypersensitivity
    • Nephritis
    • Neutropenia
    • Pseudomembranous colitis
    • Thrombocytopenia
    • Transient hepatitis
    • Toxic epidermal necrolysis
    • Urticaria
    • Vaginal discharge
    • Vomiting

    Endocarditis prophylaxis is appropriate only for high-risk patients, per American Heart Association guidelines

    Adjust dose in severe renal insufficiency (high doses may cause CNS toxicity)

    Superinfections and promotion of nonsusceptible organisms may occur with prolonged use or repeated therapy

    Prolonged treatment, hepatic or renal disease, or nutritional deficiency may be associated with increased international normalized ratio (INR)

    Prolonged use is associated with fungal or bacterial superinfection

    Use with caution in patients with history of hypersensitivity to penicillin

    There are no adequate and well-controlled studies

    Data from a published clinical lactation study reports that cephalexin is present in human milk; relative infant dose (RID) is considered to be <1% of maternal weight adjusted dose; there are no data on effects of cephalexin on breastfed child or on milk production

    Adults

    4 grams/day PO.

    Geriatric

    4 grams/day PO.

    Adolescents

    100 mg/kg/day PO (Max: 4 grams/day).

    Children

    100 mg/kg/day PO (Max: 4 grams/day).

    Infants

    100 mg/kg/day PO.

    Neonates

    Safety and efficacy have not been established; however, doses up to 15 mg/kg/day PO have been used for UTI prophylaxis.

    Cephalexin

    capsule

    • 250mg
    • 500mg
    • 750mg

    oral suspension

    • 125mg/5mL
    • 250mg/5mL

    tablet

    • 250mg
    • 500mg