1 May 2026Oral drugsSource update: January 2024
Cefalexin oral
Cefalexin guidance for common staphylococcal and streptococcal skin infections, including neonatal and pediatric dosing.
Prescription under medical supervision
This guide page is for structured reference only and does not replace a clinician, pharmacist, or emergency review. Dose choice, route choice, interactions, and safety decisions still need professional judgment.
Therapeutic action
First-generation cephalosporin antibacterial.
Indications
Skin infections due to staphylococci and/or streptococci: impetigo, furuncle, erysipelas, and superficial cellulitis.
Forms and strengths
- 250 mg capsule.
- 125 mg/5 ml powder for oral suspension to be reconstituted with filtered water and administered using a measuring device.
Dose
The exact dose should be calculated according to the newborn's weight.
- Neonate under 7 days: 25 mg/kg 2 times daily.
- Neonate 7 to 28 days: 25 mg/kg 3 times daily.
- Child 1 month to under 12 years: 12.5 to 25 mg/kg 2 times daily.
- Child 12 years and over and adult: 1 g 2 times daily.
- 1 to < 5 months and 4 to < 7 kg: 125 mg 2 times daily or 5 ml suspension 2 times daily.
- 5 months to < 3 years and 7 to < 15 kg: 187.5 mg 2 times daily or 7.5 ml suspension 2 times daily.
- 3 to < 6 years and 15 to < 20 kg: 250 mg 2 times daily or 10 ml suspension 2 times daily.
- 6 to < 12 years and 20 to < 40 kg: 500 mg 2 times daily or 2 capsules 2 times daily.
- >= 12 years and adult, >= 40 kg: 1 g 2 times daily or 4 capsules 2 times daily.
| Age | Weight | Daily dose | 125 mg/5 ml oral susp. | 250 mg capsule |
|---|---|---|---|---|
| 1 to < 5 months | 4 to < 7 kg | 125 mg x 2 | 5 ml x 2 | − |
| 5 months to < 3 years | 7 to < 15 kg | 187.5 mg x 2 | 7.5 ml x 2 | − |
| 3 to < 6 years | 15 to < 20 kg | 250 mg x 2 | 10 ml x 2 | - |
| 6 to < 12 years | 20 to < 40 kg | 500 mg x 2 | - | 2 cap x 2 |
| ≥ 12 years and adult | ≥ 40 kg | 1 g x 2 | - | 4 cap x 2 |
Duration
- Impetigo and furuncle: 7 days.
- Erysipelas and cellulitis: 7 to 10 days.
Contra-indications, adverse effects, precautions
- Do not administer to patients with allergy to cephalosporin.
- Administer with caution to patients with allergy to penicillin because cross-sensitivity may occur, and to patients with severe renal impairment by reducing the dose.
- May cause gastrointestinal disturbances, particularly diarrhoea, and allergic reactions such as skin eruption, fever, and pruritus.
- Pregnancy: no contra-indication.
- Breast-feeding: no contra-indication.
Source
MSF Essential drugs practical guidelines (January 2026)
This page reproduces the structured reference information for this batch while leaving out the Storage and Remarks sections.
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