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IE Prophylaxis Penicillin Allergy — NDEB AFK MCQ

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ModeratePharmacologyIE Prophylaxis Penicillin AllergyNDEB AFK

Which of the following is the recommended antibiotic for prophylaxis in a patient with a penicillin allergy who requires IE prophylaxis before a dental procedure?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Clindamycin 600 mg PO

For patients with a penicillin allergy requiring IE prophylaxis, clindamycin 600 mg PO 30-60 minutes before the procedure is the recommended alternative (AHA 2021 guidelines). Other alternatives include azithromycin or clarithromycin 500 mg PO. For patients without a history of anaphylaxis to penicillin, cephalexin 2 g PO may be used (first-generation cephalosporin). Metronidazole is not recommended for IE prophylaxis.

Reference: AHA – Prevention of Infective Endocarditis Guidelines, 2021