Narrow Spectrum Antibiotic — ORE Part 1 MCQ
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Correct answer: E — Phenoxymethylpenicillin
Explanation lettering: C = shown as A · D = shown as B · B = shown as C · E = shown as D · A = shown as E
A is correct. UK dental antimicrobial-stewardship guidance identifies phenoxymethylpenicillin as the preferred first-line agent for dento-alveolar infection when an antibiotic is indicated because it has a narrower spectrum of activity. Co-amoxiclav is broader spectrum and should not be selected routinely where a narrower effective agent is suitable. Clindamycin has activity against a range of aerobic and anaerobic organisms and has important adverse-effect concerns. Doxycycline is a broad-spectrum tetracycline. Metronidazole has a restricted target group—mainly anaerobes—but is not the intended narrow-spectrum stewardship answer in this comparison; it provides broad coverage within anaerobic bacteria and is commonly used as an alternative or adjunct in relevant dental infections.
Reference: Scottish Dental Clinical Effectiveness Programme, "Update to Drug Prescribing guidance now available", 2021. https://www.sdcep.org.uk/news/update-to-drug-prescribing-guidance-now-available/