Do not take this medication if you or your child have had a serious allergic reaction to penicillin. Select one or more newsletters to continue. 37 0 obj <> endobj
Prevention of rheumatic fever and diagnosis and treatment of acute Streptococcal pharyngitis: a scientific statement from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young, the Interdisciplinary Council on Functional Genomics and Translational Biology, and the Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics. Kamar A, Murray DL, Hanna CB et al. AHFS Drug Information 2003, McEvoy GK, ed.
Cephalosporins General Statement. Could Antibiotics Make Breast Milk Less Healthy for Babies? The diagnosis and management of acute otitis media. Antibacterial; β-lactam antibiotic; first generation cephalosporin.When anti-infectives indicated, AAP recommends high-dose amoxicillin or amoxicillin and clavulanate as drugs of choice for initial treatment of AOM; certain cephalosporins (cefdinir, cefpodoxime, cefuroxime, ceftriaxone) recommended as alternatives for initial treatment in penicillin-allergic patients without a history of severe and/or recent penicillin-allergic reactions.Treatment of pharyngitis and tonsillitis caused by AAP, IDSA, AHA, and others recommend a penicillin regimen (10 days of oral penicillin V or oral amoxicillin or single dose of IM penicillin G benzathine) as treatment of choice for If an oral cephalosporin used, 10-day regimen of first generation cephalosporin (cefadroxil, cephalexin) preferred instead of other cephalosporins with broader spectrums of activity (e.g., cefaclor, cefdinir, cefixime, cefpodoxime, cefuroxime).Treatment of bone and joint infections caused by susceptible staphylococci or Treatment of mild to moderate respiratory tract infections caused by susceptible Treatment of mild to moderate skin and skin structure infections caused by susceptible staphylococci or streptococci.Treatment of mild to moderate UTIs, including acute prostatitis, caused by susceptible Alternative for prevention of α-hemolytic (viridans group) streptococcal endocarditisWhen selecting anti-infectives for prophylaxis of bacterial endocarditis, consult most recent AHA recommendations for specific information on which cardiac conditions are associated with highest risk of endocarditis and which procedures require prophylaxis.Reconstitute oral suspension at time of dispensing by adding the amount of water specified on the container in 2 equal portions; shake after each addition.Reconstituted suspensions contain 125 or 250 mg of cephalexin/5 mL.Shake oral suspension well prior to administration of each dose.Available as cephalexin monohydrate; dosage expressed in terms of cephalexin.Children beyond neonatal period: AAP recommends 25–50 mg/kg daily in 2 or 4 equally divided doses for treatment of mild or moderate infections and 75–100 mg/kg daily in 3 or 4 equally divided doses for treatment of severe infections.25–50 mg/kg daily in 3–4 equally divided doses for ≥10 days.Children >15 years of age: 500 mg every 12 hours for ≥10 days.25–50 mg/kg daily in 3–4 equally divided doses for mild to moderate infections.25–50 mg/kg daily in 3–4 equally divided doses for mild to moderate infections.25–50 mg/kg daily in divided doses every 12 hours for mild to moderate infections.Children >15 years of age: 500 mg every 12 hours for mild to moderate infections.Manufacturers state dosage may be doubled for severe infections.25–50 mg/kg daily in 3–4 equally divided doses for mild to moderate infections.Children >15 years of age with uncomplicated cystitis: 500 mg every 12 hours for 7–14 days.Manufacturers state dosage may be doubled for severe infections.50 mg/kg (up to 2 g) as a single dose given 0.5–1 hour prior to the procedure.Usual dosage ranges from 1–4 g daily given in divided doses.250 mg every 6 hours for mild to moderate infections.500 mg every 12 hours for mild to moderate infections.500 mg every 12 hours for 7–14 days for mild to moderate infections.2 g as a single dose given 0.5–1 hour prior to the procedure.Use with caution in patients with markedly impaired renal function; close clinical observation and appropriate laboratory tests recommended because safe dosage may be lower than usual dosages.Some clinicians suggest that the usual adult dosage be used for the initial dose.Cautious dosage selection because of age-related decreases in renal function.Known hypersensitivity to cephalexin or other cephalosporins.Possible emergence and overgrowth of nonsusceptible bacteria or fungi with prolonged use.Treatment with anti-infectives alters normal colon flora and may permit overgrowth of Consider CDAD if diarrhea develops during or after therapy and manage accordingly.If CDAD is suspected or confirmed, discontinue anti-infectives not directed against Possible hypersensitivity reactions (e.g., urticaria, pruritus, rash, fever and chills, eosinophilia, joint pain or inflammation, edema, erythema, genital and anal pruritus, angioedema, shock, hypotension, vasodilatation, Stevens-Johnson syndrome, erythema multiforme, toxic epidermal necrolysis, exfoliative dermatitis, anaphylaxis).If a hypersensitivity reaction occurs, discontinue cephalexin immediately and institute appropriate therapy as indicated (e.g., epinephrine, corticosteroids, maintenance of an adequate airway and oxygen).Partial cross-sensitivity among cephalosporins and other β-lactam antibiotics, including penicillins and cephamycins.Prior to initiation of therapy, make careful inquiry concerning previous hypersensitivity reactions to cephalosporins, penicillins, or other drugs.Cephalosporins should be used with caution in patients with a history of GI disease, particularly colitis.Positive direct Coombs’ test results reported with cephalosporins.To reduce development of drug-resistant bacteria and maintain effectiveness of cephalexin and other antibacterials, use only for treatment or prevention of infections proven or strongly suspected to be caused by susceptible bacteria.When selecting or modifying anti-infective therapy, use results of culture and in vitro susceptibility testing.Safety and efficacy in pediatric patients is based on clinical trials that used recommended dosages administered as capsules or oral suspension.Use cephalexin capsules in children and adolescents only in those able to ingest capsules.No overall differences in safety and efficacy in adults ≥65 years of age compared with younger adults, but the possibility of increased sensitivity in some geriatric individuals cannot be ruled out.Substantially eliminated by kidneys; risk of toxicity may be greater in those with impaired renal function.Decreased clearance and increased plasma half-life.Use with caution in those with markedly impaired renal function;Reduced dosage has been recommended in those with ClAdverse GI effects, including diarrhea, nausea, vomiting, dyspepsia, gastritis, abdominal pain.Increased plasma concentrations and AUC and decreased renal clearance of metformin;Monitor closely; adjust metformin dosage if necessaryDecreased renal excretion and increased plasma concentrations of cephalexinPossible false-positive reactions in urine glucose tests using ClinitestUse glucose tests based on enzymatic glucose oxidase reactions (e.g., ClinistixAlthough peak serum concentrations are slightly lower and attained later when administered with food, total amount of drug absorbed is unchanged.Cephalosporins widely distributed into tissues and fluids.Excreted in urine as unchanged drug by renal tubular secretion and glomerular filtration.At least 70–90% of a dose eliminated in urine within 8–12 hours in adults with normal renal function.Children: about 5 hours in neonates and 2.5 hours in children 3–12 months of age.Decreased clearance and increased half-life in patients with renal impairment.20–25°C (may be exposed to 15–30°C); tight, light-resistant container.First generation cephalosporin with a limited spectrum of activity compared with second and third generation cephalosporins.Like other β-lactam antibiotics, antibacterial activity results from inhibition of bacterial cell wall synthesis.In vitro spectrum of activity includes some gram-positive aerobic bacteria and some gram-negative aerobic bacteria.Gram-positive aerobes: active in vitro and in clinical infections against gram-positive aerobic bacteria including Gram-negative aerobes: active in vitro and in clinical infections against some gram-negative aerobic bacteria including Advise patients that antibacterials (including cephalexin) should only be used to treat bacterial infections and not used to treat viral infections (e.g., the common cold).Importance of completing full course of therapy, even if feeling better after a few days.Advise patients that skipping doses or not completing the full course of therapy may decrease effectiveness and increase the likelihood that bacteria will develop resistance and will not be treatable with cephalexin or other antibacterials in the future.Advise patients that diarrhea is a common problem caused by anti-infectives and usually ends when the drug is discontinued.Importance of discontinuing therapy and informing clinician if an allergic reaction occurs.Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs as well as any concomitant illnesses.Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.Importance of informing patients of other important precautionary information.
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