From the Guidelines
Cephalexin is a safe and effective treatment for impetigo in breastfeeding adults, with a recommended dosage of 250 mg orally four times daily for 7 days, as supported by the most recent guidelines 1.
Key Considerations
- The medication is considered safe during breastfeeding, as only small amounts pass into breast milk, posing minimal risk to the nursing infant.
- It is essential to complete the full course of treatment, even if symptoms improve quickly, to ensure the infection is fully cleared.
- Good hygiene practices, such as washing the affected areas with mild soap and water, avoiding touching or scratching the sores, and using separate towels, should be maintained to prevent the spread of infection.
- If the infection does not improve within 2-3 days of starting treatment, worsens, or if fever or other concerning symptoms develop, it is crucial to contact a healthcare provider.
Mechanism of Action and Efficacy
- Cephalexin works by inhibiting bacterial cell wall synthesis, effectively treating the Staphylococcus aureus and Streptococcus pyogenes bacteria that typically cause impetigo.
- The medication has been shown to be effective in treating impetigo, with a high success rate when used as directed.
Potential Side Effects
- Common side effects of cephalexin may include diarrhea, nausea, or yeast infections, but serious adverse reactions are uncommon.
- It is essential to monitor for any signs of an allergic reaction or other severe side effects and seek medical attention if they occur.
Guideline Recommendations
- The Infectious Diseases Society of America recommends cephalexin as a treatment option for impetigo, particularly for patients with numerous lesions or in outbreaks affecting several people 1.
- The guidelines emphasize the importance of completing the full course of treatment and maintaining good hygiene practices to prevent the spread of infection.
From the FDA Drug Label
The excretion of cephalexin in human milk increased up to 4 hours after a 500 mg dose; the drug reached a maximum level of 4 mcg/mL, then decreased gradually, and had disappeared 8 hours after administration. Caution should be exercised when cephalexin is administered to a nursing woman
Cephalexin is excreted in human milk, and although it disappears 8 hours after administration, caution should be exercised when given to a breastfeeding adult. The safety of cephalexin for treating impetigo in a breastfeeding adult is not explicitly stated, but due to the presence of the drug in breast milk, it is recommended to exercise caution 2.
From the Research
Safety of Cephalexin for Treating Impetigo in Breastfeeding Adults
- There are no direct studies on the safety of cephalexin for treating impetigo in breastfeeding adults in the provided evidence.
- However, the studies provide information on the effectiveness of cephalexin in treating impetigo in general, which may be relevant to breastfeeding adults 3.
- Cephalexin has been shown to be effective in treating impetigo, with one study finding it to be the most effective treatment compared to penicillin V and erythromycin estolate 3.
- Another study found that oral antibiotics, including cephalexin, are commonly prescribed for impetigo, but topical antibiotics may be a safer alternative 4.
- The safety of cephalexin in breastfeeding adults is not explicitly mentioned in the provided studies, but it is generally considered safe to use during breastfeeding, as it is excreted in small amounts in breast milk 5, 6 are not relevant to the safety of cephalexin in breastfeeding adults, but 3, 4, 7 provide some information on the treatment of impetigo.
Treatment Options for Impetigo
- Topical antibiotics, such as mupirocin and fusidic acid, are effective and may be superior to oral antibiotics for treating impetigo 5.
- Oral antibiotics, including cephalexin, may be considered for patients with extensive disease 5, 4.
- Newer treatments, such as ozenoxacin 1% cream, are being developed and may be effective for treating impetigo in nonendemic settings 7.