Is it safe to continue Keflex (Cephalexin) treatment for a urinary tract infection while being 8 weeks pregnant?

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Last updated: November 26, 2025View editorial policy

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Keflex (Cephalexin) for UTI at 8 Weeks Pregnant

Keflex is safe and appropriate to continue for treating your urinary tract infection at 8 weeks of pregnancy. Cephalexin is considered a low-risk antibiotic during all stages of pregnancy, including the first trimester, and should not be discontinued due to pregnancy concerns alone.

Safety Profile in Early Pregnancy

  • Cephalexin is classified as pregnancy category B, indicating no evidence of fetal harm in human studies 1
  • All penicillins and cephalosporins, including cephalexin, are considered low risk throughout pregnancy based on decades of clinical experience 1, 2
  • The European Respiratory Society explicitly lists cephalosporins as "compatible" for use during the first trimester 1

Why Treatment Should Continue

Untreated urinary tract infections pose significantly greater risks to your pregnancy than the antibiotic itself. Active infections during pregnancy are associated with:

  • Increased risk of acute pyelonephritis (kidney infection) 3
  • Preterm delivery 4
  • Low birth weight 4
  • Higher rates of pregnancy complications 4

Evidence Supporting Cephalexin Use in Pregnancy

  • Cephalexin has been specifically studied for UTI prophylaxis during pregnancy with excellent safety outcomes 3
  • In a study of 33 pregnant women receiving cephalexin prophylaxis (250 mg doses), only 1 UTI occurred during pregnancy compared to 130 UTIs before prophylaxis, with no adverse fetal effects reported 3
  • Cephalexin achieves high bactericidal concentrations in the urinary tract and induces minimal resistance in bacterial flora 3, 5

Clinical Recommendations

  • Complete your full course of Keflex as prescribed - discontinuing antibiotics prematurely can lead to treatment failure and recurrent infection 3
  • If symptoms persist after 48-72 hours of treatment, contact your healthcare provider for reassessment
  • Ensure adequate hydration during treatment
  • Follow up with your obstetrician to confirm infection clearance after completing the antibiotic course

Common Pitfall to Avoid

Do not discontinue effective antibiotics during pregnancy due to unfounded safety concerns. The evidence clearly demonstrates that treating active infections during pregnancy is essential, and cephalexin is one of the safest options available 1, 2, 3. Untreated UTIs can progress to serious kidney infections that pose far greater risks to both mother and fetus than the antibiotic treatment 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Safety of Tazobactam During Pregnancy

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Effective prophylaxis for recurrent urinary tract infections during pregnancy.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 1992

Guideline

Management of Small Bowel Crohn's Disease During Second Trimester of Pregnancy

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 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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