Diferencia entre revisiones de «Cephalexin»
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==General==
==General==
*Type: 1st generation cephalosporin
*Type: [[Is Generation::1st generation]] [[Is DrugClass::cephalosporin]]
*Dosage forms
*Dosage forms
**Tabs: 250mg, 500mg, 750mg
**Tabs: 250mg, 500mg, 750mg
**Liquid: 125mg/5mL; 250mg/5mL
**Liquid: 125mg/5mL; 250mg/5mL
*Common Trade Names: Keflex
*Common Trade Names: Keflex, Keftab, Biocef


==Adult Dosing==
==Adult Dosing==
===General===
===General===
250-500mg PO q6h
*250-500mg PO q6h
*Max: 4g/day
===[[Strep Pharyngitis]]===
500mg PO q12h x 10 days


===Uncomplicated [[UTI]]===
===Indications by Disease===
500mg PO q12h x 7-14 days
{{#ask: [[Has DrugName::Cephalexin]] [[Has Population::Adult]]
 
|?Treats disease=Disease
===[[Cellulitis]] and Other Skin Infections===
|?Has Dose=Dose
500mg PO q12h
|?Has Context=Context
|format=table
|limit=50
|mainlabel=-
|headers=show
|sort=Treats disease
}}


==Pediatric Dosing==
==Pediatric Dosing==
===General===
===General===
*25-50 mg/kg/day PO divided q6-12h
*25-50mg/kg/day PO divided q6-12h
*Max: 500mg/dose


===[[Otitis Media]]===
*75-100 mg/kg/day PO divided q12h x 10 days
*Max: 4,000 mg/24h


===Community Acquired [[Pneumonia (Peds)|Pneumonia]]===
*75-100 mg/kg/day PO divided q12h x 10 days


==Contraindications==


===Skin Infections===
*25-50mg/kg/day PO divided q12h
*Max: 500mg/dose
===Indications by Disease===
{{#ask: [[Has DrugName::Cephalexin]] [[Has Population::Pediatric]]
|?Treats disease=Disease
|?Has Dose=Dose
|?Has Context=Context
|format=table
|limit=50
|mainlabel=-
|headers=show
|sort=Treats disease
}}
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B
*[[Lactation risk categories]]: Enters breast milk/L3
*Renal
**Adult
***CrCl 50-90: give q6-8h
***CrCl 10-50: give q8-12h
***CrCl <10: give q12-24h
***Hemodialysis: give dose after dialysis, no supplement
***Peritoneal dialysis: no supplement
**Pediatric
***CrCl 30-50: give q8h
***CrCl 10-29: give q12h
***CrCl <10: give q24h
***Hemodialysis: give dose after dialysis, no supplement
***Peritoneal dialysis: no supplement
*Hepatic (Adult & Pediatric)
**Not defined


==Mechanism of Action==
==Contraindications==
*Bactericidal
*Allergy to class/drug
**Inhibits cell wall
**See also [[Cephalosporin Cross-reactivity]]
*Caution advised with contraceptives


==Adverse Drug Reactions==
==Adverse Drug Reactions==
*Caution advised with contraceptives
===Serious===
*[[Anaphylaxis]]
*[[Angioedema]]
*Erythema Multiforme
*[[Stevens-Johnson Syndrome]]
*[[Toxic Epidermal Necrolysis]]
*[[Clostridium difficile]]
*Neutropenia
*[[Thrombocytopenia]]
*Hemolytic [[anemia]]
*Hemorrhage
*[[Hepatitis]]
*Cholestatic [[jaundice]]
*[[Seizures]]
 
===Common===
*[[Diarrhea]]
*Nausea/vomiting
*[[Rash]]
*[[Headache]]
*[[Dizziness]]
*Transaminitis
*Eosinophilia


==Kinetics==
==Pharmacology==
*Half-life: 1h (~20hr ESRD)
*Half-life: 1h (~20hr ESRD)
*Metabolism: Minimal
*Metabolism: Minimal
*Excretion: Primarily urine (>90% unchanged)
*Excretion: Primarily urine (>90% unchanged)
*Mechanism of Action:
**Bactericidal, inhibits cell wall


==Pregnancy/Lactation==
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
*Pregnancy = B
{| class="wikitable"
*Lactation = Safe
| align="center" style="background:#f0f0f0;"|'''Group'''
 
| align="center" style="background:#f0f0f0;"|'''Organism'''
==Overdose Management==
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
Max: 4,000 mg/day
|-
| Gram Positive||[[Strep. Group A, B, C, G]]||'''S'''
|-
| ||[[Strep. Pneumoniae]]||'''S'''
|-
| ||[[Viridans strep]]||'''S'''
|-
| ||Strep. anginosus gp||X1
|-
| ||[[Enterococcus faecalis]]||R
|-
| ||[[Enterococcus faecium]]||X1
|-
| ||[[MSSA]]||'''S'''
|-
| ||[[MRSA]]||R
|-
| ||[[CA-MRSA]]||R
|-
| ||[[Staph. Epidermidis]]||I
|-
| ||[[C. jeikeium]]||R
|-
| ||[[L. monocytogenes]]||R
|-
| Gram Negatives||[[N. gonorrhoeae]]||R
|-
| ||[[N. meningitidis]]||R
|-
| ||[[Moraxella catarrhalis]]||R
|-
| ||[[H. influenzae]]||R
|-
| ||[[E. coli]]||'''S'''
|-
| ||[[Klebsiella]] sp||'''S'''
|-
| ||E. coli/Klebsiella ESBL+||R
|-
| ||E coli/Klebsiella KPC+||R
|-
| ||[[Enterobacter]] sp, AmpC neg||R
|-
| ||[[Enterobacter]] sp, AmpC pos||R
|-
| ||[[Serratia]] sp||R
|-
| ||Serratia marcescens||X1
|-
| ||[[Salmonella]] sp||R
|-
| ||[[Shigella]] sp||R
|-
| ||[[Proteus mirabilis]]||'''S'''
|-
| ||[[Proteus vulgaris]]||R
|-
| ||[[Providencia sp.]]||R
|-
| ||[[Morganella sp.]]||R
|-
| ||[[Citrobacter freundii]]||R
|-
| ||[[Citrobacter diversus]]||R
|-
| ||[[Citrobacter sp.]]||R
|-
| ||[[Aeromonas sp]]||X1
|-
| ||[[Acinetobacter sp.]]||R
|-
| ||[[Pseudomonas aeruginosa]]||R
|-
| ||[[Burkholderia cepacia]]||R
|-
| ||[[Stenotrophomonas maltophilia]]||R
|-
| ||[[Yersinia enterocolitica]]||X1
|-
| ||[[Francisella tularensis]]||X1
|-
| ||[[Brucella sp.]]||X1
|-
| ||[[Legionella sp.]]||R
|-
| ||[[Pasteurella multocida]]||R
|-
| ||[[Haemophilus ducreyi]]||X1
|-
| ||[[Vibrio vulnificus]]||X1
|-
| Misc||[[Chlamydophila sp]]||X1
|-
| ||[[Mycoplasm pneumoniae]]||X1
|-
| ||[[Rickettsia sp]]||X1
|-
| ||[[Mycobacterium avium]]||X1
|-
| Anaerobes||[[Actinomyces]]||X1
|-
| ||[[Bacteroides fragilis]]||R
|-
| ||[[Prevotella melaninogenica]]||X1
|-
| ||[[Clostridium difficile]]||X1
|-
| ||[[Clostridium (not difficile)]]||X1
|-
| ||[[Fusobacterium necrophorum]]||X1
|-
| ||[[Peptostreptococcus sp.]]||'''S'''
|}


==IV Info==
===Key===
{{Template:Antibacterial Spectra Key}}


==See Also==
==See Also==
*[[Antibiotics (Main)]]
*[[Cephalosporin Cross-reactivity]]
*[[Cephalosporin Cross-reactivity]]


==Source==
==References==
<references/>
*Sanford 2010
*Sanford 2010
*Epocrates
*Epocrates
*Lexicomp


[[Category:Drugs]]
[[Category:Pharmacology]] [[Category:ID]]

Revisión actual - 11:08 20 mar 2026

General

  • Type: 1st generation cephalosporin
  • Dosage forms
    • Tabs: 250mg, 500mg, 750mg
    • Liquid: 125mg/5mL; 250mg/5mL
  • Common Trade Names: Keflex, Keftab, Biocef

Adult Dosing

General

  • 250-500mg PO q6h
  • Max: 4g/day

Indications by Disease

DiseaseDoseContext
Acute cystitis250mg QID x 5dOutpatient, Women Uncomplicated
Cellulitis500mg PO q6hrsOutpatient
Erysipelas500mg (6.25mg/kg) PO q6hrs x 10 daysAlternative
Felon500mg PO q6hrs daily x 7 daysOutpatient
Impetigo500mg (6.25mg/kg) PO q6hrs x 10 daysOral therapy
Mastitis500mg PO q6hrsFirst line alternative
Pyelonephritis500mg QID PO x 10-14 days (OR consider 1000mg BID)Outpatient
Streptococcal pharyngitis20 mg per kg PO BID (maximum 500 mg per dose) x 10 daysPenicillin Allergy (mild)
Suppurative parotitis500mg (12.5mg/kg) PO four times dailyOutpatient

Pediatric Dosing

General

  • 25-50mg/kg/day PO divided q6-12h
  • Max: 500mg/dose



Skin Infections

  • 25-50mg/kg/day PO divided q12h
  • Max: 500mg/dose


Indications by Disease

DiseaseDoseContext
Acute cystitis25-50mg/kg/day PO divided q6-8h x 7-10 days (max 500mg/dose)Pediatric
Acute otitis media75-100mg/kg/day PO divided q12h x 10 days; Max: 4,000mg/24hOtitis Media
Cellulitis25-50mg/kg/day PO divided q6-8h (max 500mg/dose)Pediatric Outpatient
Endocarditis50mg/kg PO (max 2g)Pediatric Dental Prophylaxis, mild PCN Allergy
Erysipelas25-50mg/kg/day PO divided q6-8h x 10 days (max 500mg/dose)Pediatric
Impetigo25-50mg/kg/day PO divided q6-8h x 7-10 days (max 500mg/dose)Pediatric Oral
Pharyngitis40mg/kg/day PO divided q12h x 10 days; Max: 500mg/doseStreptococcal Pharyngitis (>1 Year)
Pyelonephritis25-50mg/kg/day PO divided q6-8h x 10-14 days (max 500mg/dose)Pediatric Outpatient
Streptococcal pharyngitis20mg/kg PO BID x 10 days (max 500mg/dose)Pediatric PCN Allergy
Suppurative parotitis50mg/kg/day PO divided QID (max 500mg/dose)Pediatric Outpatient

Special Populations

  • Pregnancy Rating: B
  • Lactation risk categories: Enters breast milk/L3
  • Renal
    • Adult
      • CrCl 50-90: give q6-8h
      • CrCl 10-50: give q8-12h
      • CrCl <10: give q12-24h
      • Hemodialysis: give dose after dialysis, no supplement
      • Peritoneal dialysis: no supplement
    • Pediatric
      • CrCl 30-50: give q8h
      • CrCl 10-29: give q12h
      • CrCl <10: give q24h
      • Hemodialysis: give dose after dialysis, no supplement
      • Peritoneal dialysis: no supplement
  • Hepatic (Adult & Pediatric)
    • Not defined

Contraindications

Adverse Drug Reactions

Serious

Common

Pharmacology

  • Half-life: 1h (~20hr ESRD)
  • Metabolism: Minimal
  • Excretion: Primarily urine (>90% unchanged)
  • Mechanism of Action:
    • Bactericidal, inhibits cell wall

Antibiotic Sensitivities[1]

Group Organism Sensitivity
Gram Positive Strep. Group A, B, C, G S
Strep. Pneumoniae S
Viridans strep S
Strep. anginosus gp X1
Enterococcus faecalis R
Enterococcus faecium X1
MSSA S
MRSA R
CA-MRSA R
Staph. Epidermidis I
C. jeikeium R
L. monocytogenes R
Gram Negatives N. gonorrhoeae R
N. meningitidis R
Moraxella catarrhalis R
H. influenzae R
E. coli S
Klebsiella sp S
E. coli/Klebsiella ESBL+ R
E coli/Klebsiella KPC+ R
Enterobacter sp, AmpC neg R
Enterobacter sp, AmpC pos R
Serratia sp R
Serratia marcescens X1
Salmonella sp R
Shigella sp R
Proteus mirabilis S
Proteus vulgaris R
Providencia sp. R
Morganella sp. R
Citrobacter freundii R
Citrobacter diversus R
Citrobacter sp. R
Aeromonas sp X1
Acinetobacter sp. R
Pseudomonas aeruginosa R
Burkholderia cepacia R
Stenotrophomonas maltophilia R
Yersinia enterocolitica X1
Francisella tularensis X1
Brucella sp. X1
Legionella sp. R
Pasteurella multocida R
Haemophilus ducreyi X1
Vibrio vulnificus X1
Misc Chlamydophila sp X1
Mycoplasm pneumoniae X1
Rickettsia sp X1
Mycobacterium avium X1
Anaerobes Actinomyces X1
Bacteroides fragilis R
Prevotella melaninogenica X1
Clostridium difficile X1
Clostridium (not difficile) X1
Fusobacterium necrophorum X1
Peptostreptococcus sp. S

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

See Also

References

  1. ↑ Sanford Guide to Antimicrobial Therapy 2014
  • Sanford 2010
  • Epocrates
  • Lexicomp
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