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cephalexin (Keflex, Keflet, Panixine)
Tradenames: Keflex, Keflet. 1st generation cephalosporin.
Indications:
- treatment of bacterial infections due to susceptible organisms
- acute otitis media [5]
- skin or soft tissue infection
- infectious arthritis
- prophylaxis for bacterial endocarditis [5]
Dosage:
1) 250-500 mg PO q6h
2) pediatric otitis 75-100 mg/kg/day divided q6h
3) other pediatric: 25-50 mg/kg/day divided q6h
Tabs: 250, 500 mg. Elixir 125, 250 mg/5 mL.
Dispersible tablets (Panixine DisperDose):
-> disperse in water immediately before dosing [4]
Pharmacokinetics:
1) food impairs absorption
2) 1/2 life is 54 minutes Dosage adjustment with renal failure:
creatinine clearance dose
10-40 mL/min every 8-12 hours
< 10 mL/min every 12-24 hours
Antimicrobial activity:
Gram positive
- Streptococcus
- Streptococcus group A
- Streptococcus group B
- Streptococcus group C
- Streptococcus group G
- Streptococcus pneumonia
- Streptococcus viridans, Streptococcus milleri
- Staphylococcus aureus (MSSA)
- Staphylococcus epidermidis (+/-)
Gram negative
- Escherichia coli
- Klebsiella species
- Proteus mirabilis
- Moraxella catarrhalis [5]
- Haemophilus influenzae [5]
Anaerobes
- Peptostreptococcus species
Adverse effects:
1) not common (1-10%)
- diarrhea
2) uncommon (< 1%)
- dizziness, fatigue, headache, rash, nausea/vomiting, pseudomembranous colitis, neutropenia (transient), anemia, cholestatic jaundice, transient elevation of liver function tests
3) other
- abdominal cramps, pruritus, diplopia, tinnitus,
- hypersensitivity reactions (skin rashes, eosinophilia, myalgia)
- seizures (very high serum levels)
- anemia, granulocytopenia & thrombocytopenia have been reported
Test interactions:
- false positive direct antiglobulin (Coomb's) test
Laboratory:
1) specimen:
a) serum
b) keep specimen on ice-water
c) centrifuge at 4 degrees C
d) remove cells as soon as possible
e) freeze at -70 degrees C until assayed
2) methods: HPLC, MB
Interactions
drug interactions
drug adverse effects of cephalosporins
General
cephalosporin, 1st generation
Properties
MISC-INFO: elimination route KIDNEY
1/2life 54 MIN
protein-binding 14%
elimination by hemodialysis +
peritoneal dialysis -
pregnancy-category B
safety in lactation ?
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Clinical Guide to Laboratory Tests, 3rd edition,
NW Tietz ed, WB Saunders, Philadelphia, 1995
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Prescriber's Letter 10(11):64 2003
- Deprecated Reference
- Department of Veterans Affairs, VA National Formulary