Q: Is cephalexin (Keflex) an acceptable therapy for strep throat?
—Charles Liang, DO, Bloomington, Ill.

A: Yes. First-line therapy for streptococcal pharyngitis continues to be penicillin or its derivatives, but there are good data to support the use of oral cephalosporins, such as cephalexin. Controversy exists over which are better — pencillins or cephalosporins. Even though reports of clinical failure after penicillin could push the clinician to choose other antibiotics, it is good to remember that post-streptococcal diseases, such as rheumatic fever or glomerulonephritis, are rare and have not demonstrated any increased incidence while penicillins have been the standard of care.
—Cedric W. Spak, MD (98-6)

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