What is the recommended dose of Keflex (Cephalexin) for laceration repair?

Keflex (Cephalexin) Dosing for Laceration Repair

For laceration repair, the recommended adult dose of Keflex (cephalexin) is 500 mg orally every 6 hours for 7-10 days. 1

Adult Dosing

• Standard adult dosage for skin and soft tissue infections is 250 mg every 6 hours 1
• For more severe skin infections, 500 mg every 6 hours is recommended 1
• Alternative dosing of 500 mg every 12 hours may be used for skin and skin structure infections 1
• Total daily dose should be within 1-4 grams per day 1

Pediatric Dosing

• The usual recommended daily dosage for pediatric patients is 25-50 mg/kg divided into 4 doses 1
• For skin and skin structure infections in children over 1 year, the total daily dose may be divided and administered every 12 hours 1
• For severe infections in children, the dosage may be doubled 1

Weight-Based Pediatric Dosing Guidelines

Using 125 mg/5 mL suspension:

• 10 kg (22 lb): 1-2 tsp twice daily or ½-1 tsp four times daily 1
• 20 kg (44 lb): 2-4 tsp twice daily or 1-2 tsp four times daily 1
• 40 kg (88 lb): 4-8 tsp twice daily or 2-4 tsp four times daily 1

Using 250 mg/5 mL suspension:

• 10 kg (22 lb): ½-1 tsp twice daily or ¼-½ tsp four times daily 1
• 20 kg (44 lb): 1-2 tsp twice daily or ½-1 tsp four times daily 1
• 40 kg (88 lb): 2-4 tsp twice daily or 1-2 tsp four times daily 1

Duration of Therapy

• For skin and soft tissue infections, a 7-10 day course is typically recommended 2
• For more severe infections, longer treatment courses may be necessary 1

Special Considerations

• For patients with renal impairment (creatinine clearance <30 mL/min), dose reduction is required proportional to the reduced kidney function 3
• Cephalexin is contraindicated in patients with known hypersensitivity to cephalosporin antibiotics 1
• For patients allergic to penicillin, consider the risk of cross-reactivity (approximately 10%) 2

Alternative Options

• For simple, secondarily infected wounds, topical mupirocin cream applied three times daily has shown equivalent efficacy to oral cephalexin in clinical studies 4
• For MRSA infections, alternative agents such as trimethoprim-sulfamethoxazole, clindamycin, or linezolid should be considered based on local susceptibility patterns 2

Practical Administration Tips

• Cephalexin can be taken with or without food 1
• If using suspension, refrigerate after reconstitution and use within 14 days 1
• Ensure adequate hydration during treatment 3

Remember that proper wound care, including thorough cleansing and debridement if necessary, is an essential component of laceration management in addition to antibiotic therapy when indicated.