Will onychomycosis (fungal infection of the toenail) with allergies to Keflex (Cephalexin) be a concern?

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Last updated: March 28, 2025View editorial policy

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From the Guidelines

Onychomycosis, a fungal infection of the toenail, is not typically treated with antibiotics like Keflex (cephalexin), as it is a bacterial antibiotic, and therefore, an allergy to Keflex would not be a concern in the treatment of onychomycosis.

Treatment Options for Onychomycosis

  • The treatment of onychomycosis typically involves antifungal medications, such as:
    • Itraconazole: first line of treatment for dermatophyte onychomycosis, with a strength of recommendation A, as per the British Association of Dermatologists' guidelines for the management of onychomycosis 2014 1.
    • Terbinafine: first line of treatment for dermatophyte onychomycosis, and generally preferred over itraconazole, with a strength of recommendation A, as per the British Association of Dermatologists' guidelines for the management of onychomycosis 2014 1.
    • Fluconazole: may be a useful alternative in patients unable to tolerate terbinafine or itraconazole, with a strength of recommendation B, as per the British Association of Dermatologists' guidelines for the management of onychomycosis 2014 1.

Considerations for Patients with Allergies

  • If a patient has a fungal infection and is allergic to a specific medication, it is essential to inform their healthcare provider about the allergy to determine the best course of treatment.
  • In the case of onychomycosis, the treatment options are not typically affected by an allergy to Keflex (cephalexin), as it is not a commonly used medication for this condition.

Importance of Accurate Diagnosis and Treatment

  • Accurate diagnosis and treatment of onychomycosis are crucial to prevent complications and improve patient outcomes.
  • A healthcare provider should be consulted to determine the best course of treatment for onychomycosis, taking into account the patient's medical history, including any allergies.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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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