Does Keflex Cover Group B Strep UTI? Understanding Treatment for GBS in the Urinary Tract

October 11, 2025 •

3 min read

Group B Streptococcus (GBS) is a common bacterium that can cause urinary tract infections (UTIs) in adults and poses particular risks during pregnancy. In cases of GBS UTI, particularly in pregnant women, a healthcare provider may prescribe an antibiotic such as Keflex (cephalexin) to treat the infection effectively.

Quick Summary

Keflex (cephalexin) is effective for treating urinary tract infections caused by Group B Streptococcus (GBS), including during pregnancy. Its use is based on the specific infection, and it should not be confused with intrapartum GBS prophylaxis. Treatment requires a full course of medication, and alternatives are available for patients with penicillin allergies.

Key Points

Effective Treatment for GBS UTI: Keflex (cephalexin) is effective against Group B Strep and is a suitable oral antibiotic for treating GBS-induced urinary tract infections.
High Urinary Concentration: Cephalexin achieves high levels in the urine, which helps in effectively eradicating bacteria localized to the urinary tract.
Safe in Pregnancy: Keflex is considered a safe and appropriate choice for treating GBS UTI in pregnant women, helping prevent serious complications.
Mandatory Intrapartum Prophylaxis: A GBS UTI diagnosis during pregnancy requires intrapartum antibiotic prophylaxis (IAP) during labor, which is distinct from the UTI treatment itself.
Treatment Duration Varies: The duration of treatment for GBS UTI can vary based on the specific infection and patient factors.
Alternatives for Penicillin Allergy: Alternatives exist for those with penicillin allergies, with the choice depending on allergy severity and susceptibility testing.
Risks of Untreated Infection: Untreated GBS UTI, especially during pregnancy, can lead to severe complications for both mother and newborn, including preterm birth and neonatal sepsis.

Is Keflex (Cephalexin) an Effective Treatment for Group B Strep UTI?

Yes, Keflex (cephalexin) is considered an effective antibiotic for treating urinary tract infections (UTIs) caused by Group B Streptococcus (GBS). As a first-generation cephalosporin, cephalexin is a beta-lactam antibiotic with strong activity against many gram-positive bacteria, including GBS. It is readily absorbed by the body and achieves high concentrations in the urine, making it particularly well-suited for fighting bacteria in the urinary tract.

While first-line options for uncomplicated UTIs sometimes differ based on local resistance patterns, Keflex remains a reliable choice when the causative agent is identified as GBS. Its efficacy and favorable urinary pharmacokinetics are well-documented, making it a valuable tool in a healthcare provider's arsenal.

Keflex for GBS UTI in Pregnant vs. Non-Pregnant Patients

In Pregnant Patients Treating GBS in the urine during pregnancy is crucial and requires immediate antibiotic treatment. Keflex is considered pregnancy-safe and a suitable first-line option for treating GBS UTI in this population. Treatment helps prevent serious maternal and neonatal complications like premature rupture of membranes and preterm labor. A GBS UTI diagnosis during pregnancy also mandates intrapartum antibiotic prophylaxis (IAP) during labor, irrespective of later culture results.

In Non-Pregnant Adults Keflex is a standard oral option for uncomplicated GBS UTIs in non-pregnant adults. The appropriate use of the medication depends on the infection's severity and the patient's overall health.

The Crucial Distinction: GBS UTI Treatment vs. Intrapartum Prophylaxis

It is vital to distinguish between treating a GBS UTI and administering intrapartum antibiotic prophylaxis (IAP) during labor. The two serve different purposes and follow different guidelines.


Aspect	GBS UTI Treatment	Intrapartum Antibiotic Prophylaxis (IAP)
Purpose	To cure an active infection in the urinary tract.	To prevent GBS transmission from mother to baby during labor and delivery.
Initiation	Started at the time of UTI diagnosis.	Administered intravenously during labor.
Drug of Choice	Penicillin, amoxicillin, or Keflex (cephalexin) are common oral options.	Penicillin G is the preferred IV agent; ampicillin is an alternative.
Keflex's Role	An effective oral treatment option for the active UTI.	Not typically used for IAP, although other cephalosporins like cefazolin are alternatives for low-risk penicillin allergies.
Indicator for IAP	A positive GBS urine culture at any point during pregnancy is an indicator for IAP during labor.	GBS bacteriuria, positive vaginal-rectal culture near term, history of a previous affected infant, or specific risk factors during labor.

Treatment Considerations for GBS UTI

Appropriate treatment duration for Keflex varies based on individual factors and infection severity. It is essential to complete the full course to eradicate bacteria and prevent resistance.

Alternative Antibiotics for GBS UTI

For patients with a penicillin allergy, alternatives depend on the allergy type, severity, and susceptibility results. For non-anaphylactic allergies, cefazolin or nitrofurantoin may be used. For severe allergies, clindamycin (with susceptibility confirmation) or vancomycin are options.

Risks of Untreated GBS UTI

Untreated GBS UTI, especially in pregnant women, can lead to severe health consequences. Risks for the mother include pyelonephritis and postpartum infections. For the newborn, risks include sepsis, pneumonia, and meningitis without proper intrapartum prophylaxis.

Conclusion

Keflex is an effective oral antibiotic for treating GBS urinary tract infections, suitable for both pregnant and non-pregnant patients. Its use in pregnancy is safe and also necessitates intrapartum prophylaxis during labor. Completing the full course of medication is vital for preventing complications, particularly the serious risks associated with untreated infections in pregnancy. Always consult a healthcare provider for diagnosis and treatment.

*Disclaimer: The information provided is for educational purposes only and is not a substitute for professional medical advice.

Frequently Asked Questions

Yes, Keflex (cephalexin) is a good and effective oral antibiotic for treating a Group B Strep UTI because it is highly active against GBS and achieves strong antibacterial concentrations within the urinary tract.

Yes, Keflex is considered safe and is a recommended treatment option for a GBS UTI during pregnancy. It is important to treat any GBS bacteriuria during pregnancy to prevent complications, and Keflex is an appropriate choice.

Treating a GBS UTI with Keflex is for an active infection in the urinary tract. Intrapartum prophylaxis (IAP) with intravenous antibiotics like penicillin is administered during labor to prevent GBS transmission to the newborn, and a prior GBS UTI diagnosis necessitates this IAP.

The duration of treatment for a GBS UTI with Keflex can vary depending on the specific infection and individual patient factors. It is important to follow your healthcare provider's instructions regarding the length of treatment.

Yes, if you have a penicillin allergy, your doctor can prescribe alternatives. For low-risk allergies, another cephalosporin like cefazolin may be used. For severe allergies, antibiotics like clindamycin or vancomycin are alternatives, but susceptibility testing is required.

An untreated GBS UTI during pregnancy can lead to serious risks, including preterm labor, premature rupture of membranes, and potentially severe infection in the newborn (neonatal sepsis, pneumonia, or meningitis).

No, a course of Keflex for a GBS UTI will treat the current infection but will not prevent GBS colonization from recurring before delivery. A diagnosis of GBS UTI at any point during pregnancy is a definitive indication for intrapartum prophylaxis during labor to protect the newborn.