cephalexin (Keflex, Keflet, Panixine)
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Introduction
Tradenames: Keflex, Keflet. 1st generation cephalosporin.
Indications
- treatment of bacterial infections due to susceptible organisms
- prophylaxis for bacterial endocarditis[5]
Dosage
- 250-500 mg PO q6h
- pediatric otitis 75-100 mg/kg/day divided q6h
- other pediatric: 25-50 mg/kg/day divided q6h
Tabs: 250, 500 mg. Elixir 125, 250 mg/5 mL.
Dispersible tablets (Panixine DisperDose):
Pharmacokinetics
- food impairs absorption
- 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 |
elimination via kidney
1/2life = 54 min
protein binding = 14 %
elimination by hemodialysis = +
elimination by peritoneal dialysis = -
Antimicrobial activity
- Streptococcus
- Streptococcus pneumonia
- Streptococcus viridans, Streptococcus milleri
- Staphylococcus aureus (MSSA)
- Staphylococcus epidermidis (+/-)
- Escherichia coli
- Klebsiella species
- Proteus mirabilis
- Moraxella catarrhalis[5]
- Haemophilus influenzae[5]
Adverse effects
- not common (1-10%)
- uncommon (< 1%)
- dizziness, fatigue, headache, rash, nausea/vomiting, pseudomembranous colitis, neutropenia (transient), anemia, cholestatic jaundice, transient elevation of liver function tests
- 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
- specimen:
- serum
- keep specimen on ice-water
- centrifuge at 4 degrees C
- remove cells as soon as possible
- freeze at -70 degrees C until assayed
- methods: HPLC, MB
More general terms
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
- ↑ 4.0 4.1 Prescriber's Letter 10(11):64 2003
- ↑ 5.0 5.1 5.2 5.3 5.4 Deprecated Reference
- ↑ Department of Veterans Affairs, VA National Formulary
Database
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=27447
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=62921
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=2666
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=62979
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=181855
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=62980