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A prescription for a 16 kg child reads: cephalexin suspension 250 mg/5 mL, 250 mg four times daily for 7 days, for impetigo. The usual pediatric dose range is 25 to 50 mg/kg/day divided four times daily. Which of the following is the most appropriate action for the pharmacist?
The ordered dose is 250 mg x 4 = 1,000 mg/day, which is 62.5 mg/kg/day for a 16 kg child, above the usual 25-50 mg/kg/day (400-800 mg/day). The pharmacist should contact the prescriber to clarify before dispensing rather than change the dose independently (unless provincial prescribing authority allows adaptation, which still requires documentation and notification). Changing the frequency alone does not fix the total dose. Source: Cephalexin oral suspension product monograph, Pediatric dosage (DPD, checked 2026); NAPRA Model Standards of Practice (2022), prescription assessment.
Accepting a fixed adult-style dose for a child without a weight check.
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