From the Guidelines
Keflex (cephalexin) is not the first-line treatment for otitis media, but it can be effective in patients who are allergic to penicillin or as a second-line treatment. According to the most recent and highest quality study 1, the typical dosage for adults is 250-500 mg four times daily for 7-10 days, while children should receive 25-50 mg/kg/day divided into four doses. However, amoxicillin remains the first-line treatment for most uncomplicated otitis media cases due to its better coverage against Streptococcus pneumoniae, as noted in 1. Keflex works by inhibiting bacterial cell wall synthesis and is effective against many common ear infection pathogens, including Streptococcus pyogenes, Staphylococcus aureus, and some strains of Haemophilus influenzae.
Some key points to consider when treating otitis media with Keflex include:
- Completing the full course of antibiotics even if symptoms improve before finishing treatment
- Being aware of potential side effects including diarrhea, nausea, and allergic reactions
- Contacting a healthcare provider if symptoms worsen or don't improve after 48-72 hours of treatment, as a different antibiotic may be needed
- Considering the role of resistance in the treatment of otitis media, as discussed in 1, and the importance of accurate diagnosis and judicious use of antibiotics to reduce over-diagnosis, overtreatment, and antibiotic resistance, as emphasized in 1 and 1.
It's also important to note that otitis media can be caused by viral or bacterial pathogens, and the treatment approach may vary depending on the underlying cause, as discussed in 1. Overall, while Keflex can be an effective treatment for otitis media in certain cases, it's essential to carefully consider the individual patient's needs and circumstances, as well as the potential risks and benefits of treatment, to provide the best possible care.
From the FDA Drug Label
Cephalexin is indicated for the treatment of the following infections when caused by susceptible strains of the designated microorganisms: ... Otitis media due to Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Streptococcus pyogenes, and Moraxella catarrhalis In the therapy of otitis media, clinical studies have shown that a dosage of 75 to 100 mg/kg/day in 4 divided doses is required.
Keflex (cephalexin) is effective for treating otitis media caused by susceptible strains of Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, Streptococcus pyogenes, and Moraxella catarrhalis. The recommended dosage for otitis media is 75 to 100 mg/kg/day in 4 divided doses 2 2.
From the Research
Effectiveness of Keflex for Otitis Media
- Keflex (cephalexin) is not the first-line treatment for otitis media, especially when caused by Hemophilus influenzae, as shown in a study from 3 where 50% of children with H. influenzae otitis media who were treated with cephalexin responded poorly.
- However, cephalexin may be effective in treating otitis media caused by Staphylococcus aureus that is resistant to penicillin, as suggested by the same study 3.
- The effectiveness of cephalexin in treating otitis media can be limited by the increasing prevalence of penicillin-resistant Streptococcus pneumoniae, as discussed in a study from 4 which found that intermediately penicillin-resistant S. pneumoniae is associated with an impaired bacteriologic and clinical response to oral cephalosporins.
- Other antibiotics, such as amoxicillin/clavulanate, may be more effective in treating otitis media, especially in cases where additional coverage for H. influenzae is desired, as shown in studies from 5, 6, and 7.
- A study from 5 found that cefaclor, a congener of cephalexin, was effective in treating acute otitis media in children, with a clinical success rate of 98%, but this may not be directly applicable to cephalexin.
- Overall, the effectiveness of Keflex for otitis media depends on the specific causative pathogen and its susceptibility to the antibiotic, as well as the presence of any resistance mechanisms, as discussed in studies from 3, 4, 5, 6, and 7.