What is the recommended dosage of Cephalexin (Keflex) for the treatment of cellulitis?

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Last updated: March 18, 2025View editorial policy

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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 recommended dosage of Cephalexin (Keflex) for the treatment of cellulitis, which is a type of skin and skin structure infection, is 500 mg every 12 hours 1.

  • The dosage may be adjusted based on the severity of the infection.
  • For more severe infections, larger doses may be needed.
  • If daily doses of cephalexin greater than 4 g are required, parenteral cephalosporins should be considered.

From the Research

For the treatment of cellulitis, the recommended dosage of Cephalexin (Keflex) is 1000 mg taken orally four times daily for 7 days, as this high-dose regimen has been shown to have fewer treatment failures compared to the standard dose 2.

Key Considerations

  • The dosage may vary depending on the severity of the infection and the patient's clinical response.
  • Children may receive 25-50 mg/kg/day divided into four doses.
  • It is essential to take the full course of antibiotics even if symptoms improve before completion.
  • Common side effects include diarrhea, nausea, and rash.
  • If you have a penicillin allergy, inform your doctor as there is potential cross-reactivity.

Important Notes

  • Drink plenty of fluids while taking Keflex, and elevate the affected area when possible to reduce swelling.
  • Seek immediate medical attention if the infection worsens, spreads, or if you develop fever, increasing pain, or red streaks extending from the infected area.
  • The use of cephalexin plus trimethoprim-sulfamethoxazole compared to cephalexin alone did not result in higher rates of clinical resolution of cellulitis in the per-protocol analysis, but further research may be needed 3.
  • A study comparing short-course (5 days) and standard (10 days) treatment for uncomplicated cellulitis found no significant difference in clinical outcome between the two courses of therapy 4.
  • The addition of an oral anti-inflammatory agent to antibiotic treatment has been shown to significantly shorten the time to regression of inflammation and complete resolution of cellulitis 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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