Neonatal Drug Therapy Manual

Cephalexin

Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Keflex
Classification: 
Cephalosporin Antibiotic
Original Date: 
January 2009
Revised Date: 
March 2022
Indications: 
  • Treatment of noninvasive infections due to susceptible organisms.
    • Not recommended for invasive infections (e.g meningitis, bacteremia, osteomyelitis, abscesses, pneumonia)
  • UTI prophylaxis in children with congenital antenatal hydronephrosis, high-grade vesicouretral reflux or ureterovesical junction obstruction
  • Voiding Cystourethrogram (VCUG) prophylaxis (when not on prophylaxis for UTI)
Administration: 
  • PO: administer on an empty stomach, or with food if GI upset occurs
Dosage: 
Age Dose
< 7 days

50 mg/kg/day divided Q12H

Dose limit: 250 mg/day

7 - 21 days

75 mg/kg/day divided Q8H

Dose limit: 375 mg/day

> 21 days

100 mg/kg/day divided Q6H

Dose limit: 500 mg/day

 

UTI prophylaxis:

  •  15 mg/kg/day divided BID for neonates up to 6 weeks of age.  May give total daily dose once daily beyond 6 weeks of age. 

 

Voiding Cystourethrogram (VCUG) prophylaxis:(when not on prophylaxis for UTI)

  • Administer dose within 60 minutes of voiding cystourethrogram (VCUG)
    • > 35 weeks GA and < 2 weeks PNA: 25 mg/kg/dose PO x 1
    • > 35 weeks GA and > 2 weeks PNA: 50 mg/kg/dose PO x 1
    • > 35 weeks GA and > 4 weeks PNA: 75 mg/kg/dose PO x 1

Dosage adjustment required in renal impairment.  Refer to available references or clinical pharmacist for dosage adjustment.

Side Effects: 
  • GI: nausea, vomiting, diarrhea
  • Hematologic: transient neutropenia, thrombocytopenia, anemia
  • Hepatic: transient elevation in liver enzymes
Parameters to Monitor: 
  • With prolonged therapy, monitor renal, hepatic and hematologic function periodically
Reconstitution and Stability: 

N/A

Compatibility: 

N/A

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