Cephalexin Safety During Pregnancy
Cephalexin is safe to use during pregnancy as there is moderate quality evidence supporting its use with no demonstrated harm to the fetus. 1, 2
Safety Profile
- Cephalexin is classified as FDA Pregnancy Category B, indicating that reproduction studies in animals have revealed no evidence of harm to the fetus, though adequate and well-controlled studies in pregnant women are lacking 2
- The FDA label confirms that animal reproduction studies using oral doses of cephalexin monohydrate up to 1.5 times the maximum daily human dose have revealed no harm to the fetus 2
- Clinical practice guidelines specifically recommend cephalexin as a safe systemic antibiotic option for pregnant women 1
Clinical Applications During Pregnancy
- Cephalexin is particularly useful for treating urinary tract infections during pregnancy, which are common and require prompt treatment to prevent complications 3
- It can be used effectively for both asymptomatic bacteriuria and symptomatic urinary tract infections in pregnant women 3, 4
- Cephalexin has been successfully used for postcoital prophylaxis of recurrent urinary tract infections in pregnant women 5
- For hidradenitis suppurativa requiring systemic antibiotics during pregnancy, guidelines conditionally recommend cephalexin based on moderate quality evidence of safety 1
Dosing Considerations
- Standard dosing of cephalexin can be used during pregnancy, typically 250-500 mg orally every 6 hours depending on the severity of infection 6
- For urinary tract infections, a typical regimen is 500 mg every 6 hours for 7-14 days 4
- No special dose adjustments are required specifically for pregnancy 2
Advantages Over Other Antibiotics
- Cephalexin offers a safer alternative to contraindicated antibiotics during pregnancy, such as:
Clinical Monitoring
- No specific additional monitoring is required when using cephalexin during pregnancy beyond standard clinical follow-up 2
- Test of cure may be advisable after treatment of infections during pregnancy to ensure complete resolution 7
- While cephalexin is excreted in human milk, it reaches maximum levels of only 4 mcg/mL and disappears within 8 hours after administration, making it compatible with breastfeeding with appropriate caution 2
Potential Concerns
- As with all antibiotics, cephalexin should be prescribed with caution in individuals with a history of gastrointestinal disease, particularly colitis 2
- Cephalosporins may be associated with a fall in prothrombin activity in patients with renal or hepatic impairment, poor nutritional state, or those on protracted courses of therapy 2
- False-positive reactions for glucose in urine may occur with Benedict's and Fehling's solutions and Clinitest tablets 2