Keforal (Cefalexin)

Keforal (cephalexin) is a first‑generation cephalosporin antibiotic that acts on bacterial cell‑wall synthesis, making it effective for several infection types.

• Skin and soft‑tissue infections: resolves cellulitis, impetigo and wound infections by eradicating susceptible bacteria.
• Respiratory tract infections: treats acute bacterial sinusitis, bronchitis and community‑acquired pneumonia caused by susceptible organisms.
• Urinary tract infections: clears uncomplicated cystitis and pyelonephritis when pathogens are sensitive.
• Bone and joint infections: aids in the management of osteomyelitis and septic arthritis caused by susceptible strains.

• Cephalexin exerts its antibacterial activity by binding to penicillin‑binding proteins located on the bacterial cell wall. This binding inhibits the final transpeptidation step of peptidoglycan synthesis, weakening the cell wall and leading to osmotic lysis of susceptible Gram‑positive and some Gram‑negative organisms. The drug is time‑dependent, and its bactericidal effect is proportional to the duration that concentrations exceed the minimum inhibitory concentration.

Cephalexin may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Nausea: mild stomach upset that often resolves without treatment.
• Diarrhea: loose stools that may be watery.
• Abdominal pain: cramping or discomfort in the stomach area.
• Rash: mild skin redness or itching.
• Headache: transient head pain.
• Dyspepsia: indigestion or heartburn.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction with breathing difficulty and shock.
• Stevens‑Johnson syndrome: serious skin and mucous membrane disorder.
• Clostridioides difficile colitis: severe diarrhea due to bacterial overgrowth.
• Hemolytic anemia: destruction of red blood cells.
• Liver enzyme elevation: signs of hepatic injury.
• Neutropenia: low white‑blood‑cell count increasing infection risk.

When prescribing or dispensing Keforal, healthcare professionals should observe several safety considerations.

• Indication verification: confirm infection is caused by bacteria susceptible to cephalosporins.
• Renal function assessment: adjust dose in patients with impaired kidney function.
• Allergy history: avoid in patients with known hypersensitivity to penicillins or cephalosporins.
• Pregnancy and lactation: use only if benefits outweigh potential risks, as safety data are limited.
• Concomitant medications: review for drugs that may alter renal clearance or cause gut flora disruption.
• Store at ambient temperature: keep below 25 °C in the original packaging, protect from moisture and direct sunlight.

Cephalexin can interact with other medicines, influencing its effectiveness or safety profile.

Major Interactions (Avoid)

• Probenecid: reduces renal excretion of cephalexin, increasing plasma concentrations and risk of toxicity.
• Warfarin: may potentiate anticoagulant effect, requiring closer INR monitoring.
• Oral contraceptives: may decrease efficacy, increasing risk of unintended pregnancy.

Moderate Interactions (Monitor Closely)

• Aminoglycosides: concurrent use may increase risk of nephrotoxicity.
• Metformin: reduced renal clearance of metformin may raise its plasma levels.
• Antacids containing aluminum or magnesium: can impair absorption of cephalexin if taken simultaneously.