What is the recommended dose of oral cephalexin for a 76-pound boy with a puncture wound on the foot?

From the Guidelines

For a 76-pound boy with a puncture wound on the foot, the recommended dose of oral cephalexin is 20 mg per kg per dose twice daily, which equals approximately 690 mg twice daily, with a maximum dose of 500 mg per dose, so the dose should be 500 mg twice daily. When calculating the dose, it's crucial to consider the patient's weight and the recommended dosage per kilogram. According to the study 1, the recommended dose for cephalexin in patients with penicillin allergy is 20 mg per kg per dose twice daily, with a maximum of 500 mg per dose. Given the patient's weight is 76 pounds, which is approximately 34.5 kg, the calculated dose would be around 690 mg twice daily, but since the maximum dose per administration is 500 mg, the dose should be capped at 500 mg twice daily. Key considerations for the treatment include:

• The duration of treatment, which is typically 10 days, as indicated by the study 1 for similar infections.
• Maintaining consistent blood levels of the antibiotic by administering it at regular intervals.
• The possibility of taking the medication with or without food, though taking it with food may help reduce stomach upset.
• Completing the full course of antibiotics even if the wound appears to be healing well before the medication is finished.
• Thoroughly cleaning the wound and considering tetanus prophylaxis if the child's immunization status is not up to date. Cephalexin is effective for puncture wounds because it provides good coverage against common pathogens such as Staphylococcus aureus and Streptococcus species, which are often involved in skin and soft tissue infections resulting from puncture wounds, as supported by the guidelines 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.

The recommended dose of oral cephalexin for a 76-pound boy with a puncture wound on the foot is 25 to 50 mg/kg in divided doses. To calculate the dose:

• 76 pounds is approximately 34.5 kg (using 1 pound = 0.45 kg)
• The dose would be 34.5 kg * 25 mg/kg = 862.5 mg per day for the lower end of the range
• The dose would be 34.5 kg * 50 mg/kg = 1725 mg per day for the upper end of the range This can be divided into every 12 hours for skin and skin structure infections. 2

From the Research

Recommended Dose of Oral Cephalexin

The recommended dose of oral cephalexin for a 76-pound boy with a puncture wound on the foot is not directly stated in the provided studies. However, we can look at the general information about cephalexin and its usage.

• Cephalexin is an orally administered cephalosporin antibiotic, commonly used to treat bacterial infections, including those of the skin and soft tissues 3.
• The dosage of cephalexin varies depending on the infection being treated and the patient's age and weight.
• For children, the typical dosage of cephalexin is 25-50 mg/kg per day, divided into 2-4 doses 3.

Considerations for Puncture Wounds

When it comes to puncture wounds, especially those on the foot, it's essential to consider the risk of infection and the need for prompt treatment.

• Puncture wounds can be classified into two distinct types, one of which typically occurs on the foot 4.
• The fundamental trends of treatment of puncture wounds include cleansing the wound, debridement of any necrotic or devitalized tissue, and appropriate immunoprophylaxis 4.
• In some cases, oral antibiotics such as ciprofloxacin may be used to treat foot infections following nail puncture wounds, especially after surgical intervention 5.

Calculation of Dosage

Based on the typical dosage range for children, we can estimate the recommended dose of oral cephalexin for a 76-pound boy.

• Assuming a dosage of 25-50 mg/kg per day, and using the child's weight in kilograms (approximately 34.5 kg), the estimated daily dose would be 862.5-1725 mg per day.
• Divided into 2-4 doses, the estimated dose per administration would be approximately 431-862 mg every 12 hours, or 215-431 mg every 8 hours.

Please note that this is a rough estimate and the actual dosage should be determined by a healthcare professional, taking into account the specific circumstances of the patient and the infection being treated.