Which drug is the drug of choice for premedication if the patient is allergic to penicillin?

Clindamycin is considered the drug of choice for premedication in patients who are allergic to penicillin, particularly in dental procedures where there is a risk of bacterial endocarditis or infection. This is due to its effective coverage against the types of bacteria that are commonly implicated in such infections, including some strains of Streptococcus viridans.

Clindamycin belongs to the lincosamide class of antibiotics, and it has a good oral bioavailability and is effective in treating or preventing infections in patients with a history of penicillin allergy. Its mechanism of action inhibits bacterial protein synthesis, which makes it effective against these specific bacteria.

In contrast, macrolides, another class of antibiotics, can also be used if clindamycin is not available or tolerated; however, clindamycin often has a broader spectrum against anaerobes, which are significant in dental infections. Amoxicillin, while effective for premedication, is a penicillin derivative and is not suitable for someone with a documented allergy to penicillin. Tetracycline is not the preferred choice for this indication due to concerns about its efficacy in this specific context and its side effects, such as staining of teeth in young patients. Therefore, clind