For infective endocarditis prophylaxis in dental procedures for patients without penicillin allergy, which antibiotic is commonly used?

• A. Clindamycin
• B. Amoxicillin
• C. Azithromycin
• D. Doxycycline

Answer: (B)

Protecting patients at risk for infective endocarditis during dental procedures relies on delivering an antibiotic that reliably covers the oral streptococci most often responsible for the condition. Amoxicillin is the best choice for those without penicillin allergy because it is well absorbed orally and reaches protective levels quickly. A common preprocedure dose is 2 grams taken about 30 to 60 minutes before the procedure, ensuring adequate antibiotic presence during the transient bacteremia that dental work can cause.

Other drugs on the list are reserved for people with penicillin allergy or specific circumstances. Clindamycin, azithromycin, or doxycycline can be used as alternatives in those cases, but amoxicillin remains the preferred option when there is no penicillin allergy.