From the Guidelines
For non-purulent skin infections, Keflex (cephalexin) is generally more effective and preferred over Augmentin (amoxicillin-clavulanate). According to the 2014 practice guidelines for the diagnosis and management of skin and soft tissue infections by the Infectious Diseases Society of America 1, dicloxacillin or cephalexin is recommended for oral therapy in cases of ecthyma or impetigo, as they are active against Staphylococcus aureus, which is usually methicillin susceptible.
Key Considerations
- Keflex is typically prescribed at 500 mg orally four times daily or 1 gram twice daily for 5-10 days, depending on infection severity.
- Keflex provides excellent coverage against Streptococcus and methicillin-sensitive Staphylococcus aureus (MSSA), the most common causative organisms in non-purulent skin infections.
- Augmentin has a broader spectrum of activity that includes anaerobes and gram-negative organisms, which are rarely involved in typical non-purulent skin infections, making this broader coverage unnecessary and potentially contributing to antibiotic resistance.
- Additionally, Keflex generally has fewer gastrointestinal side effects compared to Augmentin, leading to better patient tolerance and compliance, as noted in the guidelines for managing skin and soft tissue infections 1.
Special Considerations
- If there is concern for mixed infection or if the patient has a true cephalosporin allergy, Augmentin may be an appropriate alternative.
- It's essential to consider the local epidemiology and resistance patterns when selecting an antibiotic for non-purulent skin infections.
- The guidelines emphasize the importance of using systemic antimicrobials judiciously to minimize the risk of antibiotic resistance and promote better patient outcomes 1.
From the Research
Comparison of Augmentin and Keflex for Non-Purulent Skin Infections
- The provided studies do not directly compare Augmentin (amoxicillin-clavulanate) and Keflex (cephalexin) for the treatment of non-purulent skin infections.
- However, the studies suggest that cephalexin is effective in treating skin and soft-tissue infections, with cure rates of 90% or higher 2.
- Cephalexin has been compared to other antibiotics, such as ofloxacin 3 and moxifloxacin 4, and has been found to be equally effective in eradicating pathogens and achieving clinical cure.
- The efficacy of cephalexin in twice-daily dosages has also been demonstrated, with no significant difference in effectiveness compared to four times daily dosing 5, 6.
- While there is no direct comparison between Augmentin and Keflex, cephalexin has been shown to be comparable to other antibiotics, such as dicloxacillin, in the treatment of staphylococcal skin infections 6.
- It is worth noting that the choice of antibiotic may depend on various factors, including the specific type of infection, patient demographics, and cost considerations 2.