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Published on: 2/24/2026
Cephalexin is a commonly used antibiotic for bacterial infections, especially skin infections like cellulitis, and most people should notice improvement within 2 to 5 days if taken exactly as prescribed.
If symptoms are not improving or are worsening, possible reasons include antibiotic resistance, a non-bacterial cause, a deeper infection or abscess, underlying health issues, or dosing problems; you may need cultures, imaging, a change in antibiotics, or drainage. There are several factors to consider and important red flags for when to seek urgent care; see below for the complete guidance and next steps.
If you've been prescribed cephalexin and your infection doesn't seem to be improving, it's normal to feel concerned. While many infections respond well to this medication, sometimes healing takes longer—or a different approach is needed.
Let's walk through what cephalexin is, why it's commonly prescribed, and what steps to take if your infection isn't getting better.
Cephalexin is a commonly prescribed antibiotic that belongs to a class of medications called cephalosporins. It works by killing bacteria that cause infections. It does this by interfering with the bacteria's ability to build their protective cell walls.
Doctors frequently prescribe cephalexin because:
However, it only works for bacterial infections—not viral infections like colds or the flu.
Cephalexin is often used to treat:
One of the most common uses is for skin infections, especially cellulitis and erysipelas. These infections can cause:
If you're experiencing these symptoms and want to better understand whether they align with Cellulitis / Erysipelas, a free AI-powered symptom checker can help you assess your condition before your next doctor's visit.
Many people begin to notice improvement within:
That said, full healing may take longer—especially with skin infections.
It's important to:
Stopping early can allow bacteria to survive and potentially return stronger.
If you're taking cephalexin and your infection isn't improving, there are several possible reasons.
Some bacteria are resistant to certain antibiotics. If the infection isn't improving after several days, your doctor may:
Antibiotic resistance is increasingly common, which is why follow-up is important if symptoms persist.
If the infection is caused by:
Then cephalexin won't help. In these cases, different treatments are needed.
Sometimes an infection:
Abscesses, for example, often require drainage in addition to antibiotics. Antibiotics alone may not fully resolve them.
Certain health conditions can delay recovery, including:
If wounds or infections heal slowly for you in general, your doctor may need to adjust your care plan.
For cephalexin to work properly:
Missing doses can reduce effectiveness.
You should contact a healthcare provider if:
Seek urgent medical care if you experience:
These symptoms can signal a more serious infection that requires immediate attention.
If cephalexin isn't working, your doctor may:
They may confirm whether the infection is bacterial.
They may switch to:
Managing blood sugar, improving wound care, or treating swelling can dramatically improve healing.
Most people tolerate cephalexin well, but possible side effects include:
Rare but serious side effects include:
If you develop:
Seek emergency care immediately.
While taking cephalexin, you can support recovery by:
If you have diabetes, monitor blood sugar closely. High blood sugar slows healing.
One of the biggest mistakes people make is assuming the antibiotic just "needs more time." While patience is important, worsening symptoms should not be ignored.
Bacterial infections can sometimes spread quickly. Early reassessment often prevents complications.
If you're noticing persistent redness, swelling, or warmth and want to check whether your symptoms match Cellulitis / Erysipelas, a quick online assessment can provide helpful guidance before reaching out to your healthcare provider.
Cephalexin is a widely used and generally effective antibiotic for bacterial infections, especially skin infections like cellulitis. Most infections begin improving within a few days.
However, if your infection isn't healing, possible reasons include:
If symptoms are not improving—or are getting worse—don't wait. Speak to a doctor promptly. Some infections can become serious if left untreated.
There's no need to panic, but there is a need to act thoughtfully and promptly.
If you're experiencing severe symptoms, rapid spreading redness, high fever, or feel generally unwell, seek immediate medical care.
Your health is too important to guess. When in doubt, speak to a doctor and get personalized medical guidance.
(References)
* Sader HS, Stilwell MG, Dowzicky MJ, Pfaller MA, Jones RN. Pharmacologic Management of Skin and Soft-Tissue Infections with Oral Cephalexin. Infect Dis Clin Pract. 2018 Sep;26(5):252-257. doi: 10.1097/IPC.0000000000000627. Epub 2018 Jun 29. PMID: 30166779.
* Pietrangeli G, Borzì G, Boccadoro S, De Simone A, De Luca V, Del Prete F, Del Porto F, De Vito R. Persistent or recurrent skin and soft tissue infections: when to suspect underlying immunodeficiency. Curr Opin Infect Dis. 2019 Apr;32(2):123-128. doi: 10.1097/QCO.0000000000000523. PMID: 30946280.
* Muthulingam A, Hsieh YC, Dhand A. Current challenges and future directions in the management of skin and soft tissue infections. Ther Adv Infect Dis. 2023 Aug 24;10:20499361231194269. doi: 10.1177/20499361231194269. PMID: 37637887; PMCID: PMC10452396.
* Ribeiro J, Cua B, Puzio T, Patel D, Strymish J, Lawler J, O'Reilly A, Gupta K, Branch-Elliman W. Antibiotic Stewardship for Skin and Soft Tissue Infections. Clin Infect Dis. 2020 Jan 22;70(3):474-482. doi: 10.1093/cid/ciz216. PMID: 31969966.
* Spellberg B, Shrestha NK, Corey GR. Strategies to combat antimicrobial resistance in skin and soft tissue infections. Lancet Infect Dis. 2021 Mar;21(3):e75-e83. doi: 10.1016/S1473-3099(20)30501-1. Epub 2020 Sep 28. PMID: 33647432.
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