cephalexin Nursing Considerations & Management

 Drug Name

Generic Name :  cephalexin

Brand Name: Apo-Cephalex (CAN), Biocef, Keflex, Novo-Lexin (CAN), Nu-Cephalex (CAN)

Classification: Antibiotic, Cephalosporin (first generation)

Pregnancy Category B

Dosage & Route

1–4 g/day in divided doses; 250 mg PO q 6 hr usual dose.

  • Skin and skin structure infections: 500 mg PO q 12 hr. Larger doses may be needed in severe cases; do not exceed 4 g/day.
Pediatric Patients

25–50 mg/kg/day PO in divided doses.

  • Skin and skin structure infections: Divide total daily dose, and give q 12 hr. Dosage may be doubled in severe cases.
  • Otitis media: 75–100 mg/kg/day PO in four divided doses.
Therapeutic actions
  • Bactericidal: Inhibits synthesis of bacterial cell wall, causing cell death.
  • Respiratory tract infections caused by Streptococcus pneumoniae, group A beta-hemolytic streptococci
  • Skin and skin structure infections caused by staphylococcus, streptococcus
  • Otitis media caused by S. pneumoniae, Haemophilus influenzae, streptococcus, staphylococcus, Moraxella catarrhalis
  • Bone infections caused by staphylococcus, Proteus mirabilis
  • GU infections caused by Escherichia coli, P. mirabilis, Klebsiella
Adverse effects
  • CNS: Headache, dizziness, lethargy, paresthesias
  • GI: Nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence, pseudomembranous colitis, hepatotoxicity
  • GU: Nephrotoxicity
  • Hematologic: Bone marrow depression
  • Hypersensitivity: Ranging from rash to fever to anaphylaxis; serum sickness reaction
  • Other: Superinfections
  • Contraindicated with allergy to cephalosporins or penicillins.
  • Use cautiously with renal failure, lactation, pregnancy.
Nursing considerations
  • History: Penicillin or cephalosporin allergy, pregnancy, or lactation
  • Physical: Renal function tests, respiratory status, skin status; culture and sensitivity tests of infected area
  • Arrange for culture and sensitivity tests of infection before and during therapy if infection does not resolve.
  • Give drug with meals; arrange for small, frequent meals if GI complications occur.
  • Refrigerate suspension, discard after 14 days.
Teaching points
  • Take this drug with food. Refrigerate suspension; discard any drug after 14 days.
  • Complete the full course of this drug even if you feel better.
  • This drug is prescribed for this particular infection; do not self-treat any other infection.
  • You may experience these side effects: Stomach upset, loss of appetite, nausea (take drug with food); diarrhea; headache, dizziness.
  • Report severe diarrhea with blood, pus, or mucus; rash or hives; difficulty breathing; unusual tiredness, fatigue; unusual bleeding or bruising.
  • Avoid alcohol while taking cephalexin.