Cephalexin

Section 1.1

Midwives may independently prescribe, order and administer this drug.

Cephalexin is a first-generation cephalosporin antibiotic. It interferes with the bacteria’s cell wall formation by weakening the cell wall, causing it to rupture and killing bacteria.

Indications and Clinical Use:

For the treatment of lactational mastitis.

Contraindications:

Documented anaphylaxis to any penicillin antibiotic.

Warnings and Precautions:

Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea (CDAD) and pseudomembranous colitis; CDAD has been observed >2 months post-antibiotic treatment. Use with caution in patients with renal impairment; modify dosage in severe impairment. Breastfed infants may develop slightly looser stools than normal.

Pregnancy:

Compatible

Lactation:

Category L1 – Compatible

Adverse Reactions:

Upset stomach, diarrhea, vomiting, vaginal infection and mild skin rash.

The following should be reported to a medical practitioner immediately: severe skin rash, itching, hives, difficulty breathing or swallowing, wheezing, unusual bleeding or bruising, sore throat, painful mouth or throat sores, jaundice and diarrhea.

Dosage and Administration:

Mastitis: 500mg PO every 6 hours (QID) for 5-7 days if the response is rapid and complete or 10-14 days as indicated.

May be taken with or without food. Taking with food may minimize gastrointestinal distress.

Onset of Action:

Rapid absorption, peak in about 1 hour.

Half Life:

Adults: 0.5-1.2 hours; prolonged with renal impairment

Elimination:

Urine (80% to 100% as unchanged drug) within 8 hours

Maximum milk concentration occurs at 4 hours after a single oral dose and gradually disappears by 8 hours after administration.