Phlexin at the gym, cephalexin at work

I’m only kinda vain I promise. I’m a firm believer that men only go to the gym to impress and intimidate other men. Health? Nah. Women? Nope. Just as I am convinced women use makeup and botox (yes I know men do too, calm down) for other women. All that to say, cephalexin. 

Flawless transition, chef’s kiss. 

Before I worked in healthcare I knew about penicillin and doxycycline. Penicillin because I was sick as a kid, why didn’t I know about antifungals then? Doxycycline because I was supposed to take 18 months of it in Kabul. I’m pretty sure I have all 540 some in a bottle somewhere as a souvenir. That’s old news, today? Cephalexin all day and all night and all day. Yes, that much. But why?

Cephalexin, or cephypoo as it is known. Is a first generation cephalosporin and a beta-lactam antibiotic. As was penicillin. Quick recap, beta-lactams inhibit cell wall synthesis and synths (they hate 80’s music) by binding to PBPs and doing to the peptidoglycan wall what the US Marines did to Fallujah. So why is cephybaby not cephacillin? Long story short it looks different (different molecular structure, and no I won’t talk about that). 

Ok. It is usually used for gram-positive cocci and some others like E. Coli, K. Pneumoniae to name a few. It has a broad range of uses from UTIs to cellulitis, staph skin infections and as prophylaxis for certain procedures. Good to know because the most common bacteria on the skin are staph and strep. So breaking the skin is a darn good way to let those buggers in. Like the Trojan horse but without the Trojans or the horse or any clever ruse. So not at all like the Trojan horse. 

In a field where there is a lot of skin surgery and minor trauma done (biopsies, cryotherapy, blistering agents) it makes some sense that our motto is “ceph-the-best for President” and it is the most commonly prescribed antibiotic there. Note, not effective against MRSA and several other bugs like enterococcus. It is considered very safe and in practice (at least where I work) we generally only switch it out for patients on metformin and warfarin or those with documentation of allergic reactions. We typically move to amoxicillin, see a past post. 

The other tidbit I learned was to reduce dosing in those with renal issues. I’m a precious post I recount that specific revelation. (Yes I may have meant to say previous but precious also works, this blog is….. my precious). It is readily absorbed PO and peaks in 6-8 hours normally. Dosed q6-12h and excreted mostly unchanged in the urine. 

Is that all about cepha-the undertaker-lexin? No. I could  keep going but I hit my 30 minute morning treadmill mark and have to make my fiancé pancakes before work. Some people need oxygen to live. Her and I? Pancakes. My alveoli actually absorb the goodness and create life force to replace my blood. 

I hope everyone has an outstanding day, week, weekend, holiday, etc… Please share here or on Facebook (I should probably make a new page) or Instagram @occasionally_preposterous OR iTunes or Spotify with the same name minus the underscore. As always, teach me, tell me this is awesome or that you ripped your ears off afterwards due to the negative value this brings to the world. Either way. Bye bye cephypoo.

References

Bacterial skin infections from DermNet NZ by Dr. Amanda Oakley in 2002

Cephalexin on Epocrates  

Cephalexin from StatPearls at the NIH National Library of Medicine by Herman and Hashmi in 2022  

Image of cellulitis from Merck Manuals Online


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