Generic Name:
Cefalexin
Brand Name:
Airex
Drug Classification:


Pharmacologic: First-generation cephalosporin
Therapeutic: Anti-infectives
Therapeutic Action/Mode of Action:
Bind to bacterial cell wall membrane, causing cell death.
Therapeutic Effects: Bactericidal action against susceptible bacteria.
Indications:
Treatment of the following infections caused by susceptible organisms:
Skin and skin structure infections (including burn wounds), Pneumonia, Urinary
tract infections, Bone and joint infections, Septicemia, Otitis media.
Contraindications:

Contraindicated In:
Hypersensitivity to cephalosporins; Serious hypersensitivity to penicillin

Use Cautiously In:
Renal impairment, history of GI disease (esp. ulcerative colitis, antibioticassociated colitis), history of penicillin allergy, geriatrics, lactation, and pregnancy.
Suggested Dose:
Adults 1–4 g/day in divided doses; 250 mg PO every 6 hr usual dose.

Skin and skin-structure infections, streptococcal pharyngitis, uncomplicated
cystitis: 500 mg PO every 12 hr. Larger doses may be needed in severe
cases; do not exceed 4 g/day.
Pediatric patients 25–50 mg/kg/day PO in divided doses.


Skin and skin-structure infections: Divide total daily dose, and give every 12
hr. Dosage may be doubled in severe cases.
Otitis media:75–100 mg/kg/day PO in four divided doses.
Side Effects:

Frequent:
Oral candidiasis, mild diarrhea, mild abdominal cramping, vaginal candidiasis.

Occasional:
Nausea, serum sickness–like reaction (fever, joint pain; usually occurs after
second course of therapy and resolves after drug is discontinued).

Rare:
Allergic reaction (rash, pruritus, urticaria).
Adverse Effects:
Antibiotic-associated colitis, other superinfections (abdominal cramps, severe
watery diarrhea, fever) may result from altered bacterial balance in GI tract.
Nephrotoxicity may occur, esp. in patients with preexisting renal disease. Patients
with history of penicillin allergy are at increased risk for developing a severe
hypersensitivity reaction (severe pruritus, angioedema, bronchospasm,
anaphylaxis).
Interactions:

DRUG:
Probenecid may increase concentration.

HERBAL:
None significant.

FOOD:
None known.

LAB VALUES:
May increase serum BUN, creatinine, alkaline phosphatase, bilirubin, LDH, ALT,
AST. May cause positive direct/indirect Coombs’ test.
Nursing Responsibilities:

Before initiating therapy, obtain a history to determine previous use of and
reactions to penicillin or cephalosporins.
R: To watch out for contraindications and cautions or any known allergies to this
drug to avoid adverse reactions. Persons with a negative history of penicillin
sensitivity may still have an allergic response.

Obtain specimens for culture and sensitivity before initiating therapy. First
dose may be given before receiving results.
R: Obtaining cultures before antibiotic use improves the chances of identifying the
offending microorganism, which improves patient care.

Observe patient for signs and symptoms of anaphylaxis (rash, pruritus,
laryngeal edema, wheezing).
R: Discontinue drug and notify health care professional immediately if these
problems occur. Keep epinephrine, an antihistamine, and resuscitation equipment
close by in case of an anaphylactic reaction.

Monitor bowel function.
R: Diarrhea, abdominal cramping, fever, and bloody stools should be reported to
health care professional promptly as a sign of pseudomembranous colitis. May
begin up to several weeks following cessation of therapy

Assess patient for skin rash frequently during therapy.
R: Discontinue cephalosporins at first sign of rash; may be life-threatening.
Stevens-Johnson syndrome or toxic epidermal necrolysis may develop.

Monitor I&O, renal function tests for nephrotoxicity.
R: High-dose therapy may cause nephrotoxicity.

Teach the patient to take this drug with food.
R: To reduce side effects of stomach irritation, including indigestion, stomach
inflammation or ulcers. Some medicines can irritate the stomach, and taking them
with food will reduce this effect.

This drug is prescribed for particular infections; tell the client not to self-treat
any other infection.
R: Self-medication is associated with the risk of inappropriate drug use, which
predisposes patients to drug interactions, masking symptoms of an underlying
disease, and development of microbial resistance.

Avoid alcohol while taking cephalexin and for 3 days after completion of
therapy.
R: Alcohol should be avoided while taking antibiotics due to the harmful
interactions that can occur.

Provide health teachings, methods of administering and monitoring the
drug, side effects and adverse reactions and safety precautions.
R: To help inform the patient with suffice knowledge, understanding, and
preparedness for self-management.
References:
Karch, A. M. (2019). Lippincott's Pocket Drug Guide for Nurses. (pp. 278-279)
Philadelphia, PA: Wolters Kluwer.
Kizior, R. & Hodgson, K. (2019). Saunders Nursing Drug Handbook 2019 (pp.
651-654). St.Louis, Missouri: Elsevier
MIMS. (n.d.). Airex. Retrieved on March 24, 2021 from
https://www.mims.com/philippines/drug/info/airex
Skidmore-Roth, L. (2019). Mosby’s 2019 Nursing Drug Reference. Thirty-second
Edition (804-811). St.Louis, Missouri: Elsevier.
Vallerand, A.H, Sanoski,C., & Deglin, J.H. (2015). Davis’s Drug Guide for
Nurses. Fourteenth Edition (pp. 295-298). Philadelphia: F.A. Davis Company