From the FDA Drug Label
For the following infections, a dosage of 500 mg may be administered every 12 hours: ... uncomplicated cystitis in patients over 15 years of age. The usual adult dose is 250 mg every 6 hours Cystitis therapy should be continued for 7 to 14 days.
The recommended dose of Keflex for uncomplicated cystitis in adults, including pregnant women, is 500 mg every 12 hours or 250 mg every 6 hours. The duration of therapy is 7 to 14 days 1.
From the Research
For pregnant women with urinary tract infections (UTIs), the most effective and safest treatment option is crucial to prevent complications and ensure the best outcomes for both mother and fetus.
Treatment Considerations
When considering the treatment of UTIs in pregnant women, it's essential to prioritize the most recent and highest quality evidence to guide clinical decisions.
- The study by 2 emphasizes the importance of correct diagnosis and discusses diagnostic measures including microscopy, dipstick, and culture, highlighting the need for a tailored approach to treatment.
- Given the increasing concern of antibiotic resistance, as noted in 3, the choice of antibiotic should be based on its efficacy, safety, and the propensity to select for resistance.
Recommended Treatment
The recommended dose of Keflex (cephalexin) for pregnant women with UTIs is typically 500 mg orally every 6 hours or 1 gram every 12 hours for 7-14 days, depending on infection severity.
- It's crucial to obtain a urine culture before starting treatment to confirm the infection and ensure the bacteria are susceptible to Keflex, as suggested by 4.
- Completing the full course of antibiotics, even if symptoms improve quickly, is vital to prevent recurrence and potential complications.
Safety and Efficacy
- Keflex is considered pregnancy category B, indicating it is generally safe during pregnancy with no evidence of fetal risk in human studies, as mentioned in the example answers.
- However, the most recent study 2 suggests that nitrofurantoin, fosfomycin, and pivmecillinam are recommended due to their activity and low propensity to select for resistance, which may influence the choice of antibiotic in certain cases.
Monitoring and Follow-Up
Pregnant women should stay well-hydrated during treatment and report any worsening symptoms, fever, flank pain, or lack of improvement after 48-72 hours of treatment, as these may indicate a more serious kidney infection requiring different management.
- The study by 5 highlights the importance of balancing the risks of adverse events with the potential benefits of decreasing collateral ecological damage when selecting prophylactic treatments.