From the Guidelines
Keflex (cephalexin) is generally considered safe during pregnancy, with a recommended dose of 20 mg per kg per dose twice daily (maximum = 500 mg per dose) for 10 days, as suggested by the IDSA guideline for managing group A streptococcal pharyngitis 1. The typical dosing for most infections during pregnancy is 250-500 mg orally every 6 hours or 500-1000 mg every 12 hours, with treatment duration typically 7-14 days depending on the infection being treated. Some key points to consider when prescribing Keflex during pregnancy include:
- The maximum daily dose should not exceed 4 grams.
- Keflex is classified as FDA pregnancy category B, meaning animal studies have not shown risk to the fetus, and there are no adequate studies in pregnant women showing adverse effects.
- This antibiotic works by inhibiting bacterial cell wall synthesis and is effective against many gram-positive bacteria and some gram-negative organisms.
- Common indications during pregnancy include urinary tract infections, skin infections, and respiratory tract infections.
- Side effects may include gastrointestinal disturbances like nausea or diarrhea. As with any medication during pregnancy, Keflex should only be used when clearly needed and prescribed by a healthcare provider who is aware of the pregnancy, as they will weigh the potential benefits against any risks for your specific situation, and recent guidelines suggest its safe use in pregnancy 2, 3.
From the FDA Drug Label
Pregnancy Teratogenic Effects Pregnancy category B Reproduction studies have been performed on mice and rats using oral doses of cephalexin monohydrate 0.6 and 1. 5 times the maximum daily human dose (66 mg/kg/day) based upon mg/m2, and have revealed no harm to the fetus. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed
The dose of Keflex in pregnancy is not explicitly stated in the drug label. However, it is mentioned that the maximum daily human dose is 66 mg/kg/day based on mg/m2, and reproduction studies in mice and rats have revealed no harm to the fetus at doses up to 1.5 times this amount 4. The FDA label does not provide a specific dosage recommendation for pregnant women.
From the Research
Keflex Dose in Pregnancy
There is no direct information available in the provided studies regarding the dose of Keflex (cephalexin) in pregnancy.
Available Information on Cephalexin
- Cephalexin is a first-generation oral cephalosporin that has been used to treat various infections, including urinary tract infections and respiratory tract infections 5, 6.
- The usual dose of cephalexin for adults is 250-500 mg every 6 hours 7.
- Cephalexin has been shown to be effective against a range of bacterial pathogens, including Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae 5.
- Cephalexin can be conveniently administered as 500 mg twice or thrice daily 6.
Considerations for Use in Pregnancy
- There is no specific information available in the provided studies regarding the use of cephalexin in pregnancy.
- However, cephalosporins are generally considered safe to use during pregnancy, but the decision to use any antibiotic during pregnancy should be made after careful consideration of the potential benefits and risks 8, 9.
Key Points to Consider
- The dose and duration of cephalexin treatment should be determined based on the specific infection being treated and the patient's individual needs.
- Cephalexin is generally well-tolerated, but it can cause adverse effects such as gastrointestinal upset and allergic reactions 7, 5.
- The use of cephalexin in pregnancy should be carefully monitored, and the patient should be informed of the potential risks and benefits of treatment 8, 9.