What is the recommended prophylactic antibiotic for endocarditis?

The recommended prophylactic antibiotic for endocarditis is amoxicillin 2 grams taken orally. This choice is based on clinical guidelines which suggest amoxicillin is effective at preventing bacterial endocarditis in patients at high risk during certain dental or surgical procedures.

Amoxicillin works well against the types of bacteria commonly associated with endocarditis, particularly the streptococci that can enter the bloodstream during dental work. The dosing of 2 grams is appropriate to ensure adequate coverage and effectiveness.

In contrast, the other options do not align with the standard prophylactic recommendations for endocarditis. For instance, ciprofloxacin, while an antibiotic, is not typically used for endocarditis prophylaxis. Metronidazole does not cover the primary pathogens associated with endocarditis effectively. Vancomycin, although a critical antibiotic for treating serious infections caused by resistant bacteria, is not the first line for prophylaxis in endocarditis due to its spectrum of activity and potential side effects when used unnecessarily.

In summary, amoxicillin is the appropriate choice due to its effectiveness, targeted action, and established guidelines supporting its use in prophylactic scenarios involving endocarditis.