From the Guidelines
Keflex (cephalexin) is not the first-line treatment for uncomplicated urinary tract infections (UTIs) due to its relatively low efficacy and higher propensity for collateral damage compared to other available agents, as recommended by the most recent guidelines 1.
Treatment Options
The treatment of UTIs typically involves the use of antibiotics, with the choice of agent depending on various factors such as the severity of the infection, local resistance rates, and patient-specific considerations.
- Nitrofurantoin, trimethoprim-sulfamethoxazole, and fosfomycin are generally considered first-line agents for the treatment of uncomplicated cystitis due to their efficacy and lower propensity for collateral damage 1.
- For patients with pyelonephritis, trimethoprim-sulfamethoxazole or a first-generation cephalosporin may be reasonable first-line agents, depending on local resistance rates 1.
Use of Keflex
Keflex (cephalexin) may be considered as an alternative agent for the treatment of UTIs, particularly in cases where other recommended agents cannot be used. However, its use should be guided by culture and sensitivity testing to ensure efficacy against the causative pathogen.
- The typical adult dosage of Keflex is 500 mg taken orally every 12 hours, or 250 mg every 6 hours, for 7-14 days depending on infection severity.
- Common side effects of Keflex include diarrhea, nausea, and allergic reactions.
Important Considerations
It is essential to complete the full course of antibiotics even if symptoms improve, drink plenty of water during treatment, and notify the healthcare provider if symptoms worsen or do not improve within 2-3 days.
- Patients with penicillin allergies should use Keflex cautiously due to the potential for cross-reactivity.
- Pregnant women should consult their doctor before taking Keflex or any other antibiotic.
From the FDA Drug Label
Genitourinary tract infections, including acute prostatitis, caused by Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae Cephalexin is indicated for the treatment of genitourinary tract infections, including those caused by Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae 2. Key points:
- Cephalexin is effective against certain strains of bacteria that cause UTIs
- It is essential to perform culture and susceptibility tests to ensure the bacteria are susceptible to cephalexin
- Cephalexin should only be used to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria 2
From the Research
Keflex (Cephalexin) for UTI Treatment
- Cephalexin is a commonly prescribed first-generation cephalosporin for the treatment of urinary tract infections (UTIs) 3, 4, 5, 6.
- The optimal dosing interval for cephalexin in UTIs has been studied, with some research suggesting that twice-daily dosing is as effective as four-times-daily dosing 3, 6.
- A retrospective multicenter cohort study found no difference in treatment failure between patients treated with cephalexin 500 mg twice daily and those treated with 500 mg four times daily 3.
- Another study found that short courses of twice-daily cephalexin appear to be a safe and effective option for the empiric treatment of uncomplicated UTIs 4.
- Cephalexin has been shown to have good early bacteriological and clinical cures in UTIs due to non-extended-spectrum beta-lactamase-producing (ESBL) Enterobacteriaceae 5.
Efficacy and Safety of Cephalexin for UTI Treatment
- Cephalexin has been found to be effective in treating UTIs caused by Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis susceptible to cefazolin 6.
- The treatment failure rates for cephalexin twice daily versus four times daily were found to be similar in a retrospective, single-center cohort study 6.
- Cephalexin has been shown to be a safe option for the treatment of UTIs, with few reported adverse events 3, 4.
- The use of cephalexin as a fluoroquinolone-sparing alternative has been suggested, particularly in cases where fluoroquinolone resistance is a concern 5.
Dosage and Administration of Cephalexin for UTI Treatment
- Cephalexin can be administered as 500 mg twice or thrice daily, similar to cefadroxil (500 mg twice daily) 5.
- Twice-daily dosing of cephalexin may be a reasonable option for the outpatient management of UTIs diagnosed in the emergency department, increasing adherence and decreasing cost without compromising effectiveness 6.