Cephalexin Safety in G6PD-Deficient Patients

Evidence-Based Safety Profile

• The American Academy of Pediatrics and other guideline societies recommend that only seven medications are definitively contraindicated in G6PD deficiency, and cephalexin is not among them 1

Clinical Use in Pediatric Patients

• The Infectious Diseases Society of America recommends cephalexin for treating methicillin-susceptible Staphylococcus aureus infections in children, with a preferred oral dose of 75-100 mg/kg/day divided into 3 or 4 doses, with no special restrictions or warnings for G6PD-deficient patients 2, 3, 4

Important Caveats

• The severity of G6PD deficiency varies by genetic variant, with the Mediterranean variant being more severe and the African variant being milder 1, 5
• When using cephalexin in a G6PD-deficient patient, monitor for signs of hemolysis, including jaundice, dark urine, fatigue, and pallor 1

Practical Dosing

• The standard cephalexin dosing for a 1-year-old child is 75-100 mg/kg/day divided into 3-4 doses for most infections, with no dose adjustment needed for G6PD deficiency 2, 3, 4