From the Guidelines
For a 62kg child with bilateral ingrown toenail infection, the recommended dosage of Keflex (cephalexin) is 25 mg/kg/day in 4 divided doses, which translates to approximately 1550 mg total daily dose, or 387.5 mg four times daily. According to the practice guidelines for the diagnosis and management of skin and soft-tissue infections 1, the dosage of cephalexin for children is 25 mg/kg/day in 4 divided doses. This recommendation is based on the treatment of impetigo, which is a skin infection caused by Staphylococcus and Streptococcus species, similar to the common bacteria causing ingrown toenail infections.
Some key points to consider when treating ingrown toenail infections with Keflex include:
- Ensuring the child completes the full course of antibiotics, even if symptoms improve before completion
- Using warm soaks of the affected toes 3-4 times daily as an adjunctive measure
- Proper nail trimming technique (straight across) to prevent further irritation
- Wearing properly fitting shoes to reduce pressure on the toes
It is also important to note that if there is significant inflammation, pus, or no improvement after 48-72 hours of treatment, the child should be reevaluated as surgical intervention might be necessary. The recommended treatment duration is typically 7-10 days, depending on the clinical response 1.
From the FDA Drug Label
Pediatric Patients The usual recommended daily dosage for pediatric patients is 25 to 50 mg/kg in divided doses For streptococcal pharyngitis in patients over 1 year of age and for skin and skin structure infections, the total daily dose may be divided and administered every 12 hours. In severe infections, the dosage may be doubled.
For a 62kg child with bilateral ingrown toe nail infection, which is a skin and skin structure infection, the recommended daily dosage is 25 to 50 mg/kg.
- The child's weight is 62kg, so the daily dose would be:
- 25 mg/kg: 62kg x 25 mg/kg = 1550 mg
- 50 mg/kg: 62kg x 50 mg/kg = 3100 mg
- The dose can be divided and administered every 12 hours.
- Since the infection is not specified as severe, the dosage should not be doubled.
- A suitable dosing regimen could be 1550 mg to 3100 mg per day, divided into 2 doses of 775 mg to 1550 mg every 12 hours 2.
From the Research
Dosing for Keflex in a 62kg Child
The provided studies do not directly address the best dosing for Keflex in a 62kg child with bilateral ingrown toenail infection. However, we can look at the general treatment approaches for ingrown toenails and the use of antibiotics in these cases.
Treatment Approaches for Ingrown Toenails
- Conservative treatment approaches include soaking the foot in warm, soapy water; placing cotton wisps or dental floss under the ingrown nail edge; and gutter splinting with or without the placement of an acrylic nail 3.
- Surgical approaches include partial nail avulsion or complete nail excision with or without phenolization 3.
- In the pediatric population, nail avulsion plus chemical matrixectomy (CM) using NaOH as an alternative to surgical matrixectomy (SM) has been used in the treatment of ingrown toenails 4.
Use of Antibiotics
- Oral antibiotics before or after phenolization do not improve outcomes in the treatment of ingrown toenails 3.
- In the pediatric population, treatment with antibiotics within the preceding week of surgery was associated with a lower recurrence rate of ingrown toenails 4.
- However, the use of antibiotics is usually not needed if adequate drainage is achieved, unless the patient is immunocompromised or a severe infection is present 5.
Keflex Dosing
There is no specific information provided on the dosing of Keflex for a 62kg child with bilateral ingrown toenail infection. The dosing of antibiotics such as Keflex is typically based on the severity of the infection, the patient's weight, and other factors, and should be determined by a healthcare professional.
Note: The study 6 is not relevant to the treatment of ingrown toenails or the use of antibiotics, and therefore is not cited in this response.