Cephalexin

Indications

• Uncomplicated skin and soft tissue infections.
  • Impetigo.
  • Folliculitis.
  • Furuncles.
  • Carbuncles.
  • Cellulitis.
  • Ecthyma.
  • Erysipelas.
  • Sycosis Barbae.
  • Postoperative wound infections.

• Severe infections(iv).
  • Complicated cellulitis.
  • Necrotizing fasciitis.

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Dosage

• Cephalexin : 25–100 mg/kg/day divided q6h or q12h (pediatric dosge) & 250–500 mg 4 times daily (adult dosage).
• Impetigo :250 mg 4 times per day PO (adults) & 25 mg/kg/day in 4 divided doses PO (children).
• Skin And Soft Tissue Infection: (Methicillin-Susceptible S. Aureus): 500 mg 4 times per day PO (adults) & 25 mg/kg/day in 4 divided doses PO (children).
• Non–Purulent Cellulitis:500 mg PO 4 times daily  10-day course.
• Sycosis Barbae : 500 mg four times a day.
• Infections following Animal or Human Bites: 500 mg four times per day.
• Staphylococcus Aureus Suppression In Atopic Dermatitis :Cephalexin  250 mg four times daily 2-week course.

Renal Dosing.

• CrCL 10–40 mL/min: q8–12h.
• CrCl < 10 mL/min: q12–24h.

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Side effects

Frequency Not Defined

• 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.

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Contraindications

• Hypersensitivity to drug/class.

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Interactions

• Nephrotoxicity: aminoglycosides.
• Increased levels of cephalosporins: probenecid.
• Decreased efficacy of cephalosporins: oral contraceptives.

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Pregnancy &Lactation

• Category B.
• Excreted into human milk, Occasionally disruption of the infant’s gastrointestinal flora, resulting in diarrhea or thrush have been reported with cephalosporins, Cephalexin is acceptable in nursing mothers.

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Precautions

• Adjust dose in severe renal insufficiency (high doses may cause CNS toxicity).
• Prolonged use is associated with fungal or bacterial superinfection.
• Prolonged treatment, hepatic or renal disease, or nutritional deficiency may be associated with increased international normalized ratio (INR).
• Use with caution in patients with history of hypersensitivity to penicillin.

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Drug Info

• Cephalexin is best absorbed from an empty stomach.
• Nail changes have been described following treatment with cephalexin