From the Guidelines
The pediatric dosing for cephalexin is 20 mg per kg per dose twice daily, with a maximum of 500 mg per dose, as recommended by the strongest and most recent evidence 1.
Key Considerations
- The dosing should be adjusted based on the child's weight and the severity of the infection being treated.
- Cephalexin is available as capsules, tablets, and oral suspension, making it a convenient option for pediatric patients.
- The duration of treatment typically ranges from 7-14 days depending on the infection type, with most uncomplicated infections requiring 7-10 days of therapy.
Evidence-Based Recommendation
The recommended dosing for cephalexin in pediatric patients is based on the evidence from the IDSA updates guideline for managing group A streptococcal pharyngitis 1, which provides a strong and high-quality recommendation for the use of cephalexin in patients with penicillin allergy.
Important Notes
- The dose of 20 mg per kg per dose twice daily is specifically recommended for patients with penicillin allergy, as stated in the guideline 1.
- Other studies, such as the practice guidelines for the diagnosis and management of skin and soft tissue infections 1, may provide additional information on the use of cephalexin in pediatric patients, but the strongest and most recent evidence supports the dosing recommended in the IDSA guideline 1.
From the FDA Drug Label
Pediatric Patients The usual recommended daily dosage for pediatric patients is 25 to 50 mg/kg in divided doses For streptococcal pharyngitis in patients over 1 year of age and for skin and skin structure infections, the total daily dose may be divided and administered every 12 hours.
Cephalexin Suspension Weight 125 mg/5 mL 250 mg/5 mL 10 kg (22 lb) 1/2 to 1 tsp q.i.d. 1/4 to 1/2 tsp q.i.d. 20 kg (44 lb) 1 to 2 tsp q.i.d. 1/2 to 1 tsp q.i.d. 40 kg (88 lb) 2 to 4 tsp q.i.d. 1 to 2 tsp q.i. d.
or
Weight 125 mg/5 mL 250 mg/5 mL 10 kg (22 lb) 1 to 2 tsp b.i.d. 1/2 to 1 tsp b.i.d 20 kg (44 lb) 2 to 4 tsp b.i.d. 1 to 2 tsp b.i.d. 40 kg (88 lb) 4 to 8 tsp b.i.d. 2 to 4 tsp b.i. d.
The paediatric dosing amount for cephalexin is 25 to 50 mg/kg in divided doses, with specific dosing instructions provided for different weights and administration frequencies 2.
- For patients over 1 year of age with streptococcal pharyngitis or skin and skin structure infections, the dose may be divided and administered every 12 hours.
- The dose may be increased in severe infections.
- For otitis media, a dosage of 75 to 100 mg/kg/day in 4 divided doses is recommended.
From the Research
Paediatric Dosing of Cephalexin
- The provided studies do not directly address the paediatric dosing amount for cephalexin 3, 4, 5, 6, 7.
- These studies focus on the use of cephalosporins, such as cefazolin, in patients with penicillin allergies, and the safety of administering cefazolin versus other antibiotics in penicillin-allergic patients for surgical prophylaxis.
- They do not provide information on the specific dosing of cephalexin for paediatric patients.
- Therefore, there are no research papers among the provided evidence to assist in answering this question.