What is the next best antibiotic if somebody is allergic to Cephalexin (Keflex)?

From the Guidelines

If someone is allergic to Keflex (cephalexin), the next best antibiotic would typically be clindamycin, as recommended by recent guidelines 1. For adults, the standard dosage is 300-450 mg taken orally every 6-8 hours for 7-10 days, depending on the type and severity of infection. For children, the dosage is usually 8-25 mg/kg/day divided into three or four doses. Clindamycin is particularly effective against many of the same gram-positive bacteria that Keflex treats, including Staphylococcus and Streptococcus species. It's essential to consider the type of infection being treated, the patient's medical history, and local resistance patterns when selecting an alternative antibiotic, as noted in studies 1. Patients should take the full course of antibiotics even if symptoms improve before completion. Common side effects of clindamycin include diarrhea, nausea, and abdominal pain. If severe diarrhea occurs, the patient should contact their healthcare provider immediately, as this could indicate Clostridioides difficile infection, a serious potential complication of clindamycin therapy. Some key points to consider when choosing an alternative antibiotic include:

• The severity of the infection and the patient's medical history
• Local resistance patterns and the specific bacteria being targeted
• The potential for cross-reactivity with other antibiotics, such as penicillins and cephalosporins, as discussed in studies 1
• The risk of adverse effects, such as Clostridioides difficile infection, and the need for close monitoring. Overall, clindamycin is a suitable alternative to Keflex for patients with a cephalosporin allergy, but it's crucial to weigh the benefits and risks and consider individual patient factors, as recommended by recent guidelines 1.

From the Research

Alternatives to Keflex

If somebody is allergic to Keflex (cephalexin), there are several alternative antibiotics that can be considered.

• Doxycycline is a potential alternative, as it has been shown to be effective in treating skin and soft tissue infections, including those caused by streptococcal and staphylococcal bacteria 2, 3.
• Minocycline and omadacycline are other oral tetracyclines that can be used to treat skin and soft tissue infections, although their use may be limited by resistance patterns 2.
• Clindamycin and dicloxacillin are also effective against streptococcal and staphylococcal infections, and may be considered as alternatives to cephalexin 4.
• Erythromycin and other cephalosporins, such as cefadroxil, may also be used to treat skin and soft tissue infections, although their efficacy and safety profiles may vary 5, 4.

Considerations for Choosing an Alternative

When choosing an alternative to cephalexin, several factors should be considered, including:

• The type and severity of the infection
• The patient's medical history and allergies
• The resistance patterns of the suspected pathogens
• The efficacy and safety profiles of the alternative antibiotics
• Cost and availability of the alternative antibiotics 4, 2.