From the Guidelines
The recommended dosing of Cephalexin (Keflex) for pediatric patients is 20 mg per kg per dose twice daily, with a maximum of 500 mg per dose, for 10 days, as indicated for patients with penicillin allergy 1.
Key Considerations
- The dosing is based on the patient's weight, with a maximum dose to ensure safety and efficacy.
- The treatment duration is typically 10 days, but may vary depending on the specific infection being treated.
- Cephalexin is a first-generation cephalosporin that works by inhibiting bacterial cell wall synthesis, making it effective against many gram-positive bacteria and some gram-negative organisms.
Administration and Formulation
- Cephalexin can be administered with or without food, though taking it with food may reduce gastrointestinal side effects.
- The medication comes in oral suspension (125 mg/5 mL or 250 mg/5 mL) for younger children and capsules (250 mg, 500 mg, 750 mg) for older children who can swallow pills.
Evidence-Based Recommendation
- The recommended dosing is based on the strongest and most recent evidence available, which is the 2013 guideline update for managing group A streptococcal pharyngitis 1.
- This guideline provides a strong, high-quality recommendation for the use of Cephalexin in pediatric patients with penicillin allergy.
- Other studies, such as the 2014 practice guidelines for the diagnosis and management of skin and soft tissue infections, also support the use of Cephalexin in pediatric patients, but with slightly different dosing recommendations 1. However, the 2013 guideline update provides the most recent and highest-quality evidence for the recommended dosing of Cephalexin in pediatric patients.
From the FDA Drug Label
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. In severe infections, the dosage may be doubled. 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.
The recommended dosing of Cephalexin (Keflex) for pediatric patients is:
- 25 to 50 mg/kg per day in divided doses
- For specific infections:
- Streptococcal pharyngitis: divide total daily dose and administer every 12 hours
- Skin and skin structure infections: divide total daily dose and administer every 12 hours
- Otitis media: 75 to 100 mg/kg per day in 4 divided doses
- In severe infections, the dosage may be doubled 2
From the Research
Recommended Dosing of Cephalexin for Pediatric Patients
- The recommended dosing of Cephalexin for pediatric patients is not explicitly stated in the provided studies, except for one study that mentions the dose used in the treatment of group A beta-hemolytic streptococcal throat infections 3.
- In the study on group A beta-hemolytic streptococcal throat infections, the dose of cephalexin used was 27 mg/kg per day, divided into four doses, for 10 days 3.
- Another study mentions the use of cephalexin in the treatment of lower urinary tract infections in children, with a dose of 25-50 mg/kg body weight per day for 3 days 4.
- It is essential to note that the dosing of cephalexin may vary depending on the specific infection being treated and the age and weight of the child.
Comparison with Other Antibiotics
- A study on faropenem, a novel oral carbapenem, mentions the recommended clinical dose in pediatric patients as 15 mg/kg/day, divided into three doses 5.
- Another study on cefoperazone, a third-generation cephalosporin, mentions the recommended dose range for children as 50-200 mg/kg/day 6.
- These studies suggest that the dosing of antibiotics can vary significantly depending on the specific medication and the infection being treated.