A patient with penicillin allergy (anaphylaxis) requires antibiotic cover for an elective procedure. Amoxicillin-clavulanate is contraindicated. The best antibiotic alternative that covers oral streptococci for endocarditis prophylaxis is:
- A Ciprofloxacin
- B Metronidazole
- C Clindamycin ✓
- D Gentamicin
Correct answer: C. Clindamycin
Explanation
Current AHA/ESC guidelines recommend clindamycin as the alternative for endocarditis prophylaxis in penicillin-allergic patients undergoing dental procedures involving gingival manipulation. Clindamycin has excellent activity against viridans streptococci and good oral bioavailability. Ciprofloxacin lacks reliable streptococcal coverage. Metronidazole covers anaerobes but not streptococci. Gentamicin is not used as a single agent for this purpose in outpatient prophylaxis.
Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.