Keftab (Cephalexin): Comprehensive Patient Guide for Australia
Basic Product Information
| International Nonproprietary Name (INN) | Cephalexin |
|---|---|
| Australia Brand Names | Keftab®, Cephalexin Sandoz, Cephalexin Alphapharm, Ceflex, Apo-Cephalexin |
| ATC Code | J01DB01 |
| Available Forms & Strengths | Tablets: 250 mg, 500 mg Capsules: 250 mg, 500 mg Powder for Oral Suspension: 125 mg/5 mL, 250 mg/5 mL |
| Manufacturer(s) | Abbott, Sandoz, Alphapharm, Generic Manufacturers |
| Prescription Status | Prescription only (S4, Australia Poisons Schedule) |
Mechanism of Action
In simple terms: Keftab (cephalexin) is an antibiotic that helps your body fight bacterial infections by stopping bacteria from building their protective cell walls, causing them to die.
For specialists: Cephalexin is a first-generation cephalosporin antibacterial agent. It binds to penicillin-binding proteins (PBPs), interfering with the final stage of peptidoglycan synthesis—and thus, cell wall biosynthesis—leading to cell lysis and death in susceptible organisms.
- Primarily bactericidal
- Active against many Gram-positive and some Gram-negative bacteria
- Not effective against MRSA or most Enterococci
Pharmacokinetics
- Absorption: Well absorbed from the gastrointestinal tract; peak plasma levels in 1 hour.
- Distribution: Distributed widely in tissues and body fluids; crosses placenta; minimal in cerebrospinal fluid.
- Metabolism: Minimally metabolised in the liver.
- Elimination: Excreted mainly unchanged in the urine; elimination half-life approx. 0.5–1.2 hours in adults with normal renal function.
- Duration of action: Active in the body for 6–12 hours per dose; requires dosing every 6 or 12 hours depending on severity and indication.
Use in Everyday Life and Best Practices
- Typical Doses: For adults, usually 250–500 mg every 6–12 hours; follow prescriber’s recommendation based on infection type.
- How to Use: Take entire course exactly as prescribed, even if you feel better after a few days.
- Australia Context: Keftab is a common choice for uncomplicated urinary tract infections (UTIs), skin infections, respiratory infections, and throat infections in the community. Its oral form makes it suitable for use at home.
- Do not share antibiotics; always consult your doctor or pharmacist if unsure.
Dosing – Morning vs Evening
- Split Doses: Most regimens require doses every 6–12 hours, so prescribe times—e.g., morning and evening—should be kept 12 hours apart.
- Advantages: Taking doses at the same times each day (e.g., breakfast/dinner) improves adherence and effectiveness.
- Tips: Use a pill box, phone alarms, or link doses to daily routines like meals.
- For once-daily therapy: Take at a regular time that suits your lifestyle, following your prescriber’s advice.
- Missed dose: Take as soon as remembered; if close to next dose, skip and continue regular schedule (do not double doses).
Taking with Food or On an Empty Stomach
- Cephalexin may be taken with or without food.
- With Food: Taking with food or milk can help reduce potential stomach upset—a common recommendation for those prone to gastrointestinal sensitivity.
- Without Food: Absorption is not significantly affected; it's suitable for those who prefer taking medicines apart from meals.
- Australia Dietary Habits: You can take Keftab with typical Australian meals (toast, porridge, fruit, etc.); avoid only if you have been told to fast for other medical reasons.
Interaction Warnings
| Type | Interaction Details |
|---|---|
| Antacids | May slightly reduce absorption; best to separate doses by at least 2 hours. |
| Probenecid | Increases cephalexin blood levels, risk of side effects. |
| Metformin | Use with caution; monitor blood sugar closely. |
| Oral contraceptives | Antibiotics like cephalexin rarely affect efficacy, but seek advice if severe diarrhoea/vomiting occurs. |
| Alcohol | No direct interaction, but avoid excessive consumption as it may worsen infection recovery or side effects. |
| Other Antibiotics | Do not mix cephalosporins with aminoglycosides/furosemide intravenously (rare, hospital setting). |
Indications
| Official Indications (PBS Approved) | Off-label/Other Uses (as per clinical guidelines) |
|---|---|
| - Respiratory tract infections (pharyngitis, tonsillitis, bronchitis) - Uncomplicated urinary tract infections (cystitis, pyelonephritis) - Skin and soft tissue infections (cellulitis, impetigo, wound infections) - Bone and joint infections (osteomyelitis) | - Dental infections (as alternative; see ADA guidelines) - Otitis media (middle ear infection) - Prophylaxis of rheumatic fever - Selected animal or human bite infections |
Dosing According to Clinical Indications
| Indication | Adults | Paediatric | Elderly/Adjustment |
|---|---|---|---|
| UTI, respiratory, skin infections | 250–500 mg every 6–12 hours (max 4 g/day) | 25–50 mg/kg/day in divided doses (max 4 g/day) | Reduce dose in renal impairment; otherwise same as adults |
| Bone & joint infections | 500 mg–1 g every 6 hours | 50–100 mg/kg/day in divided doses | As above; close monitoring of renal function |
| Dental infections | 500 mg every 6 hours (per ADA) | 25–50 mg/kg/day in divided doses | Reduce dose for decreased renal function |
Always follow your prescriber or pharmacist's personalised advice.
Safety Profile and Side Effects
| Common | Less Common | Serious/Rare |
|---|---|---|
| - Diarrhoea - Nausea, vomiting - Abdominal pain - Headache | - Mild rash - Tiredness - Vaginal thrush - Mild dizziness | - Severe allergic reaction (anaphylaxis, angioedema, breathing difficulty, severe rash) - Severe diarrhoea (possible Clostridioides difficile infection) - Blood disorders (rare) - Kidney problems (if pre-existing renal disease) |
- Report any new rash, swelling, difficulty breathing, or persistent diarrhoea to a healthcare provider immediately.
- If you experience mild side effects, consult your pharmacist for advice.
Guidelines for Proper Use
- Complete the full course—even if you feel better early; stopping too soon may lead to resistant bacteria or relapse.
- Check the expiry date and storage instructions (room temperature or fridge for reconstituted suspension).
- Keep out of reach of children and tightly closed.
- For powder for suspension: shake well before each dose and measure carefully with supplied syringe/cup.
- If symptoms persist after finishing the course, contact your GP for review.
- Safe for use during pregnancy and breastfeeding if prescribed—seek advice for your specific situation.
- Notify your doctor of any known severe allergies, especially to penicillins or other cephalosporins.
- Report any unusual bruising, severe fatigue, or yellowing of the skin or eyes.
- Do not use for viral infections (e.g., cold, flu); not effective against such conditions.
- For Aboriginal and Torres Strait Islander communities: discuss with your ACCHO provider for culturally appropriate care and follow-up.
Alternative Treatment Options
- Amoxicillin (PBS reimbursed): Similar spectrum, but less effective for some skin infections where resistance occurs.
- Flucloxacillin (PBS): Preferred for suspected Staphylococcus aureus infections; not for those allergic to penicillins.
- Sulfamethoxazole with trimethoprim (Bactrim, PBS): Effective for UTI, some resistance emerging; not suitable for everyone.
- Nitrofurantoin (for UTI, PBS): Suitable for simple UTIs, not for tissue infections.
- Each alternative has specific pros/cons (e.g., dosing convenience, allergy profile, spectrum)—discuss with your doctor or pharmacist to determine best fit. Not all are suitable for all infections or individual patients.
Legal, Registration, and Reimbursement Status in Australia
- TGA Status: Registered prescription medicine in Australia (ARTG listed).
- Prescription Only: S4 (Schedule 4), available from pharmacies after seeing a GP or authorised provider.
- PBS (Pharmaceutical Benefits Scheme): Listed for most standard indications; subsidised cost for eligible patients, including concession card holders.
- Supplied in pack sizes as per PBS regulations; repeats require ongoing clinical review as per Australian guidelines.
Latest Research and Clinical Guidance (2022–2025)
- Therapeutic Guidelines (eTG complete, Australia, 2023): Cephalexin remains first-line for mild skin/soft tissue infections and some community-acquired UTIs, but not for hospital-acquired or highly resistant strains. Use only as directed.
- NPS MedicineWise (2024): Emphasises safe antibiotic prescribing, with clear patient advice to avoid misuse and reduce risk of resistance.
- Cochrane Reviews (2022–2024): No new safety concerns identified; confirms cephalexin’s efficacy and safety in children and adults for mainstream indications.
- National Centre for Immunisation Research (NCIRS, 2024): Confirms safe use for selective bacterial complications post-influenza or viral respiratory illness.
Availability and Delivery
| Form/Strength | Typical Pack Size (PBS & Retail) | Indicative Price (AUD, PBS concessional/co-pay) | Estimated Delivery (to major cities) |
|---|---|---|---|
| Capsules 500 mg | 20–40 capsules | $6.80 (PBS co-pay), $14–$20 (private) | Sydney/Melbourne: 0–1 business days Brisbane/Perth/Adelaide: 1–2 business days Regional: 2–4 business days |
| Powder for suspension | 100 mL, 200 mL after preparation | $6.80 (PBS co-pay), $15–$18 (private) | As above |
Same-day delivery or in-pharmacy collection may be available in central locations. Cold-chain packaging offered for suspensions if needed in summer.
Frequently Asked Questions (FAQ)
- How quickly should I feel better after starting Keftab?
Most people notice improvement in symptoms within 48–72 hours, depending on the type of infection. Always finish your course as prescribed, even if symptoms improve. - What if I miss a dose?
Take the missed dose as soon as you remember. If it’s nearly time for the next dose, skip the missed dose and resume your regular schedule. Do not double up doses to make up for a missed one. - Can I drink alcohol while taking Keftab?
Modest alcohol intake is unlikely to interact with cephalexin, but excessive drinking can slow your recovery and increase side effects such as stomach upset. - Is Keftab safe for children or during pregnancy?
Yes, when prescribed appropriately. It is commonly used in Australian children and is usually safe in pregnancy and breastfeeding, but always consult your doctor before starting any medication. - Do I need to avoid any foods while on Keftab?
No specific foods need to be avoided. Take with or without meals as suits you, but food can help lessen stomach upset for some people.
Further information
If you have questions, speak to your pharmacist or GP, or refer to Healthdirect Australia or the Therapeutic Goods Administration for updated advice and consumer medicines information.
