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 cephalexin for balanitis in a child is 25 to 50 mg/kg in divided doses. Since balanitis is a skin and skin structure infection, the total daily dose may be divided and administered every 12 hours 1.
From the Research
For balanitis in a child, the recommended dose of cephalexin is typically 45 mg/kg/dose (maximum 1.5 g) three times daily, as this regimen has been shown to be effective and well-tolerated in children with similar infections 2. This dosing strategy is based on the most recent and highest quality study available, which demonstrated that a high-dose cefalexin regimen of 45 mg/kg/dose (maximum 1.5 g) three times daily achieves the same pharmacodynamic target as more frequent dosing regimens, making it a convenient and effective option for treating balanitis in children. Some key points to consider when administering cephalexin to children include:
- Ensuring proper hygiene measures are implemented, including gentle cleansing of the affected area with warm water (avoiding soap), keeping the area dry, and avoiding tight-fitting clothing.
- Completing the full course of antibiotics even if symptoms improve before completion.
- Exercising caution if the child has a known allergy to penicillins due to potential cross-reactivity, and considering an alternative antibiotic if necessary. It's also important to note that cephalexin is a first-generation cephalosporin antibiotic that works by inhibiting bacterial cell wall synthesis, making it effective against many gram-positive bacteria that commonly cause balanitis, including Staphylococcus and Streptococcus species 2. While other studies have suggested different dosing regimens, such as twice-daily or four times daily dosing 3, 4, the most recent and highest quality study supports the use of a high-dose, three times daily regimen 2. Additionally, other antibiotics like cefpodoxime proxetil have been shown to be effective in treating various bacterial infections in children, but cephalexin remains a suitable option for balanitis due to its efficacy and tolerability 5.