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Cefalexin prescribing appropriateness in general practice: an evaluation study

Ibrahim S Al-Busaidi1, Sarmad Qamar1, Yao-Min Lin1

  • 1Department of Primary Care and Clinical Simulation, University of Otago, PO Box 4345, Christchurch 8140, New Zealand.

Journal of Primary Health Care
|October 24, 2025
PubMed
Abstract

Insights

This study found that over half of cefalexin prescriptions in New Zealand were not fully guideline compliant or clinically appropriate. Interventions are needed to improve antimicrobial stewardship and cefalexin prescribing practices.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Public Health

Background:

  • Antimicrobial resistance is a growing global threat driven by antibiotic misuse.
  • Cephalexin is a second-line antibiotic, but its community use is increasing in New Zealand.
  • This trend necessitates a closer examination of cefalexin prescribing patterns.

Purpose of the Study:

  • To evaluate the appropriateness and guideline adherence of cefalexin prescriptions.
  • To identify areas for improvement in antimicrobial stewardship.

Main Methods:

  • A cross-sectional study was conducted at an urban medical center in Christchurch, NZ.
  • Prescriptions from July-August 2023 were reviewed for guideline compliance and clinical appropriateness.
  • A modified audit survey based on national and regional guidelines was utilized.

Main Results:

  • 27 cefalexin prescriptions were analyzed.
  • Soft tissue and genito-urinary infections were the most common indications.
  • Only 53.8% of prescriptions were guideline compliant, and 57.7% were clinically appropriate.

Conclusions:

  • The study highlights suboptimal cefalexin prescribing in primary care.
  • Targeted antimicrobial stewardship interventions are recommended.
  • A larger, multicenter study is planned for further investigation.
Keywords:
New Zealandantibiotic stewardshipantimicrobial resistancecefalexincommunity prescribinggeneral practitionersguideline complianceprimary care

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