What is the drug of choice for endocarditis prophylaxis?

In the context of endocarditis prophylaxis, the drug of choice is amoxicillin. This selection is based on its effectiveness and safety profile for preventing infective endocarditis in patients who are at high risk, such as those with certain heart conditions or who have undergone particular dental procedures.

Amoxicillin is favored due to its oral bioavailability and broad spectrum of activity against the bacteria typically responsible for causing endocarditis, particularly Streptococci and other common pathogens. The standard prophylactic regimen involves administering amoxicillin prior to dental procedures to minimize the risk of bacteremia leading to endocarditis.

When considering the other medications listed, while they may have roles in treating infections or providing alternative prophylactic options in certain cases (for instance, when patients are allergic to penicillin), they are not the first-line choice for prophylaxis against endocarditis. Amoxicillin remains the go-to option in guidelines provided by various medical organizations for effective prevention strategies.