What is the dosage of Cephalexin (Keflex) for surgical site infection (SSI)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 19, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

Keflex (cephalexin) should be prescribed at a dosage of 500 mg every 6 hours orally for the treatment of surgical site infections (SSI). This recommendation is based on the guidelines for the diagnosis and management of skin and soft tissue infections, as outlined in the 2014 update by the Infectious Diseases Society of America 1. The dosage may need to be adjusted for patients with reduced kidney function. It is essential to obtain cultures when possible to confirm the appropriate antibiotic choice, as Keflex is effective against many gram-positive bacteria commonly causing SSIs, including Staphylococcus aureus and Streptococcus species, but has limited coverage against gram-negative organisms. Some key points to consider when prescribing Keflex for SSI treatment include:

  • Completing the full course of antibiotics, even if symptoms improve quickly, to prevent recurrence and antibiotic resistance
  • Monitoring for common side effects, such as gastrointestinal disturbances, and instructing patients to report severe diarrhea, rash, or signs of an allergic reaction immediately
  • Advising patients to take Keflex with food if stomach upset occurs and to maintain adequate hydration during treatment
  • Considering alternative antibiotics, such as dicloxacillin, cefazolin, or vancomycin, depending on the specific causative organism and patient factors, as outlined in the guidelines 1.

From the Research

Keflex Dosage for SSI

  • The provided studies do not specifically mention the dosage of Keflex (Cephalexin) for surgical site infections (SSI) 2, 3, 4, 5, 6.
  • However, it is mentioned that adjusted antibiotic use and adequate wound drainage are sufficient strategies for superficial SSI management 2.
  • Aggressive surgical debridement and effective antimicrobial therapy are needed to optimize the treatment of SSI 3.
  • The use of appropriate dosing, timing, and choice of preoperative parenteral antimicrobial prophylaxis is recommended to prevent SSI 4.
  • Cefazolin is a first-line agent for prevention of SSI after total joint arthroplasty, and its use is associated with decreased postoperative SSI without an increase in interoperative hypersensitivity reactions 5.
  • New antibiotics such as avibactam and dalbavancin may be alternatives to existing treatment for SSI, but should be used only on the ground of susceptibility testing and if standard drugs are inappropriate 6.

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.