What is the recommended dose of cephalexin (Cephalexin) for a skin infection?

From the Guidelines

For a skin infection, the recommended dose of cephalexin for adults is typically 500 mg taken orally every 6 hours, or 1 gram every 12 hours, for 7-14 days depending on the severity of the infection, as indicated in the practice guidelines for the diagnosis and management of skin and soft-tissue infections 1. The dosage for children is usually 25 mg per kg of body weight daily, divided into four equal doses, as stated in the guidelines 1. Key points to consider when taking cephalexin include:

• Taking the medication with or without food, though taking it with food may help reduce stomach upset
• Drinking plenty of water while on this medication
• Completing the duration of treatment entirely, even if symptoms improve before the medication is finished, to ensure complete eradication of the infection and prevent antibiotic resistance
• Informing the doctor of any history of cephalosporin or penicillin allergy before starting this medication
• Monitoring for signs of an allergic reaction, such as a rash or severe diarrhea, and contacting the healthcare provider immediately if they occur It's also important to note that cephalexin works by inhibiting bacterial cell wall synthesis, making it effective against many common skin pathogens including Staphylococcus aureus and Streptococcus species 1. However, it's worth mentioning that another study found first-generation cephalosporins, such as cephalexin, to be ineffective for treatment of Lyme disease 1, but this is not directly relevant to the treatment of general skin infections.

From the FDA Drug Label

For the following infections, a dosage of 500 mg may be administered every 12 hours: streptococcal pharyngitis, skin and skin structure infections, and uncomplicated cystitis in patients over 15 years of age. 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 a skin infection is:

• 500 mg every 12 hours for adults and children over 15 years of age 2
• 25 to 50 mg/kg in divided doses for pediatric patients, which can be administered every 12 hours for skin and skin structure infections 2

From the Research

Cephalexin Dosage for Skin Infections

The recommended dose of cephalexin for skin infections can vary depending on the severity and type of infection.

• For uncomplicated skin and skin-structure infections, a dose of 500 mg four times daily for 7 to 10 days is commonly used 3, 4.
• In some cases, a dose of 250 to 500 mg every 6 hours may be prescribed 5.
• It's essential to note that patients with creatinine clearances less than 30 ml/min may require a reduction in cephalexin dosage, which should be proportional to the reduced function 5.

Comparison with Other Antibiotics

Cephalexin has been compared to other antibiotics in the treatment of skin infections:

• A study comparing cefdinir and cephalexin for the treatment of skin and skin-structure infections found that cefdinir 300 mg twice daily was as effective as cephalexin 500 mg four times daily for 10 days 3.
• Another study compared cephalexin plus trimethoprim-sulfamethoxazole to cephalexin alone for the treatment of uncomplicated cellulitis and found no significant difference in clinical cure rates between the two groups 4.
• Cephalexin has also been compared to dicloxacillin and moxifloxacin in the treatment of staphylococcal skin infections and uncomplicated skin infections, respectively, with similar efficacy and safety profiles 6, 7.

Important Considerations

When prescribing cephalexin for skin infections, it's crucial to consider the following:

• The dosage and duration of treatment may vary depending on the severity and type of infection.
• Patients with renal impairment may require dose adjustments.
• Cephalexin may not be effective against all types of bacteria, and antibiotic resistance should be considered when selecting a treatment regimen 5, 3, 4, 6, 7.