Spectrum: Local Antimicrobial Stewardship, for Prisma Health Children’s Hospital-Midlands

Cephalexin

C. diff Risk

Medium

Oral Bioavailability

Excellent

Approximate Cost

$$

Spectrum Of Activity

General Spectrum of Activity

Spectrum Of Activity

General Spectrum of Activity

Antibiogram Data

Dosing

Pediatric

Neonatal

25 mg/kg, PO, 3xdaily

Renal

<10 mL/minute/1.73 m2standard dose, daily (max dose: 500mg)

Hemodialysis/Peritoneal dialysisstandard dose, daily (max dose: 500mg)

10 to 29 mL/minute/1.73 m2standard dose, twice daily (max dose: 500mg)

General Information

Acceptable Uses

Acceptable Uses

Skin and soft tissue infections
Bone and Joint Infections
Pneumonia (if organism susceptible)
UTI

Unacceptable Uses

Unacceptable Uses

Resistant strep. pneumoniae

Drug Monitoring

Drug Monitoring

With prolonged therapy, monitor renal, hepatic, and hematologic function periodically

First Line Indications

First Line Indications

Uncomplicated skin and soft tissue infection (cellulitis)
MSSA infections

Adverse Effects

Adverse Effects

Hypersensitivity, rash
Can cause positive Coombs
Cytopenias, eosinophilia.

Major Interactions

Major Interactions
  • Zinc containing supplements (administer 3 hours after cephalexin)

Oral Liquids

Oral Liquids

250mg/5ml suspension

Tablet/Capsule Strengths

Tablet/Capsule Strengths

250mg, 500mg capsules

Additional Information

Additional Information
  • same side chain as ampicillin -caution in patients allergic to ampicillin

Pharmacology

Pharmacology

Antimicrobial class: First generation cephalosporin - oral

Pregnancy category: B

Average serum half life:

  • Neonates: 5 hours

  • Children 3 to 12 months: 2-3 hours

  • Adults: 1 hour

Biliary penetration: Low

CSF penetration: Poor

Lung penetration: Good

Urine penetration: Excellent (80-100% excreted as unchanged drug)

Route of Elimination: 80% to 100% of dose excreted as unchanged drug in urine within 8 hours