Cephalexin (Keflex) versus ...

Cephalexin vs. Cefadroxil
  • Efficacy:
    • Pyodermas. Once-daily cefadroxil offers greater bacteriologic eradication and a better overall effective response than twice-daily cephalexin for the treatment of pyodermas caused by gram-positive pathogens in children and adolescents.
    • Streptococcal tonsillopharyngitis. Cephalexin twice daily or three times daily and cefadroxil once daily appear equivalent in bacteriologic and clinical cure of streptococcal tonsillopharyngitis 4.
  • Side effects and tolerability: Cefadroxil may be given at less frequent intervals than cephalexin.

Cephalexin vs. Cefdinir
  • Efficacy:
    Skin and skin-structure infections. Cefdinir is as effective as cephalexin in the treatment of mild-to-moderate skin and skin-structure infections. In the study significantly more isolated pathogens were resistant to cephalexin than to cefdinir 2
  • Side effects and tolerability: Cefdinir is associated with the higher rate of adverse reactions than cephalexin 2.

Cephalexin vs. Cephradine
  • Efficacy: Cephradine was compared to cephalexin a randomized, double-blind study for the treatment of bacterial infections in children. Both proved to be equally safe and effective for use paediatric practice 1.

Cephalexin vs. Penicillin
  • Efficacy:
    • Group A streptococcal throat infections. Cephalexin is a more effective than penicillin in the treatment of group A beta-hemolytic streptococcal throat infection in children 7.
    • Impetigo. Cephalexin is much more effective treatment, than penicillin V for impetigo 8.


Cephalexin vs. Ofloxacin
  • Efficacy:
    • Skin, skin structure, and soft-tissue infections. Both ofloxacin and cephalexin are safe and effective in the treatment of skin and soft-tissue infections 5.

Cephalexin vs. Azithromycin
  • Efficacy:
    • Skin and skin structure infections. A five-day, once-daily regimen of azithromycin is as effective as a ten-day, twice-daily regimen of cephalexin in the treatment of skin and skin structure infections 6.

Results of randomised study comparing efficacy of azithromycin versus cephalexin for infection prophylaxisis in simple traumatic wounds 10 Cephalexin Azithromycin
Regimen 1000 mg before wound repair followed by 250 mg every 6 hours for 5 days 500 mg before the wound repair followed by 250 mg/day for 5 days
Rate of infection after treatment completion 9.6% 5.4%
Azithromycin is more cost-effective compared to cephalexin for infection prophylaxisis in simple traumatic wounds

Cephalexin vs. Minocycline
  • Efficacy:
    • Bacterial prostatitis. In multicenter study more patients in the minocycline-treated group had both clinical and bacteriologic cures (35%) than did those in the cephalexin-treated group (21%) 9.

Further reading

  • 1. Mouallem R. Comparative efficacy and safety of cephradine and cephalexin in children. J Int Med Res. 1976;4(4):265-71. PubMed
  • 2. Tack KJ, Littlejohn TW, Mailloux G, Wolf MM, Keyserling CH. Cefdinir versus cephalexin for the treatment of skin and skin-structure infections. Clin Ther. 1998 Mar-Apr;20(2):244-56 PubMed
  • 4. Curtin CD, Casey JR, Murray PC, Cleary CT, Hoeger WJ, Marsocci SM, Murphy ML, Francis AB, Pichichero ME. Efficacy of cephalexin two vs. three times daily vs. cefadroxil once daily for streptococcal tonsillopharyngitis. Clin Pediatr (Phila). 2003 Jul-Aug;42(6):519-26. PubMed
  • 5. Powers RD, Schwartz R, Snow RM, Yarbrough DR III. Ofloxacin versus cephalexin in the treatment of skin, skin structure, and soft-tissue infections in adults. Clin Ther. 1991 Nov-Dec;13(6):727-36. PubMed
  • 6. Kiani R. Comparison of azithromycin and cephalexin in the treatment of skin and skin structure infections. Eur J Clin Microbiol Infect Dis. 1991 Oct;10(10):880-4. PubMed
  • 7. Disney FA, Dillon H, Blumer JL, Dudding BA, McLinn SE, Nelson DB, Selbst SM. Am J Dis Child. 1992 Nov;146(11):1324-7. PubMed
  • 8. Demidovich CW, Wittler RR, Ruff ME, Bass JW, Browning WC. Impetigo. Current etiology and comparison of penicillin and cephalexin therapies. Am J Dis Child. 1990 Dec;144(12):1313-5. PubMed
  • 9. Paulson DF, Zinner NR, Resnick MI, Childs SJ, Love T, Madsen PO. Treatment of bacterial prostatitis. Comparison of cephalexin and minocycline. Urology. 1986 Apr;27(4):379-87. PubMed
  • 10. Ghafouri HB, Zare M, Bazrafshan A, Edalatkhah A, Abazarian N. Azithromycin versus Cephalexin for Simple Traumatic Wounds in the Emergency Department: A Randomised Trial. Glob J Health Sci. 2016 Oct;8(10):54891. PubMed

Published: March 31, 2008
Last reviewed: February 17, 2017


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