Generic Name: Cephalexin Trade name: Keflex

Pharmacologic Class: Antibiotic, 1st generation Usual dose: 250-500 mg PO q6hr, 1-4 g/day in
Cephalosporin divided doses
Action (What does it do? How long does it take to Uses for this medication: Bacterial infections, skin
work?): Bactericidal - weakens bacterial cell wall, infections, pneumonia, UTI, septicemia, otitis
causing cell death. Active against many gram- media and bone infections.
positive pathogens.
Becomes effective after one hour, but can take up
to 48 hours to see improvement in symptoms
Common side effects:
 CNS: Headache, dizziness, lethargy, paresthesias, seizures
 GI: Nausea, vomiting, diarrhea (C-difficile-associated diarrhea), anorexia, abdominal
pain, flatulence, pseudomembranous colitis, hepatotoxicity
 GU: Nephrotoxicity
 Hematologic: Bone marrow depression
 Hypersensitivity: Ranging from rash to fever to anaphylaxis; serum sickness reaction
 Other: Superinfections

Clinical Judgment
Pre-administration assessment: What should the nurse assess before administering the medication?
- Hx of hypersensitivity reactions to cephalosporins/penicillin
- Hx of other drug allergies
- Renal function
- Bowel functions – N/V/D
- Culture & sensitivity
- Vitals, WBC count
-
How will the nurse know if it is appropriate to administer?
- Within safe dose range
- No medication/supplement contraindications
- No severe renal impairment
- No Hx of hypersensitivity reactions to cephalosporins/penicillin
-
Post- administration assessment: What should the nurse assess after administering the medication?
How will you know if the medication is effective?
- Monitor for rash, fever, diarrhea
- WBC count, temperature – resolution of S&S of infection?
- If not improved w/in 7-14 days obtain cultures for alternative Abx options

Nursing considerations:
- Avoid alcohol while taking cephalexin
- Take with food to minimize stomach discomfort
- Complete the full course of this drug as prescribed even if you feel better
- Use cautiously with renal failure, lactation, pregnancy
- Contraindicated with certain live vaccines (cholera, typhoid, BCG)
- Multivitamin with minerals should not be taken orally at the same time – zinc may decrease the
effectiveness
- Combined use with loop diuretics or aminoglycosides may increase renal toxicity
- Probenecid may cause prolonged effects