Cephalexin in Patients with Renal Disease

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Abstract
Cephalexin was administered to patients with renal impairment to study kinetics and devise a basis for predictable therapy in uremia. The mean peak serum level of 24 μg milliliter was independent of renal function. Peak levels occurred at 30 minutes after 500 mg orally in normal subjects and were undetectable by four hours. In severe renal failure, peak levels occurred at four to eight hours, and detectable levels for 72 hours. The mean half-life of cephalexin on hemodialysis was 6.3 hours as compared to 30.8 hours without dialysis. A fitted regression line describes the relation between the half-life and creatinine clearance so that if one value is known, the corresponding function may be read and dosage modified individually. The dosage frequency suggested is every 48 to 60 hours with a creatinine clearance of 0–4 ml per minute, every 24 hours for one of 5 to 15 ml per minute and every eight to 12 hours for one of 16 to 30 ml per minute. No modification is necessary at creatinine clearances above 30 ml per minute.