Which antibiotic is a preferred option for a pregnant woman with a history of infective endocarditis and a penicillin allergy?

Which antibiotic is a preferred option for a pregnant woman with a history of infective endocarditis and a penicillin allergy?

• A. Amoxicillin
• B. Cephalexin
• C. Clarithromycin
• D. Ciprofloxacin

Answer: (C)

In the context of a pregnant woman with a history of infective endocarditis and a penicillin allergy, clarithromycin is considered a preferred option due to its efficacy as a macrolide antibiotic. It is effective against a range of bacteria, including those that are typically responsible for endocarditis. Additionally, while clarithromycin can cross the placenta, its safety profile in pregnancy is deemed acceptable for certain conditions, making it a viable choice for this population when penicillin is contraindicated due to an allergy. Amoxicillin is a penicillin and would not be appropriate for someone with a documented allergy to penicillins. Cephalexin, a first-generation cephalosporin, has some cross-reactivity with penicillin allergies, and thus caution is warranted when considering it for a patient with a penicillin hypersensitivity history. Ciprofloxacin, a fluoroquinolone, is not recommended during pregnancy due to potential adverse effects on fetal development. Therefore, clarithromycin stands out as the most suitable antibiotic in this scenario.

In the context of a pregnant woman with a history of infective endocarditis and a penicillin allergy, clarithromycin is considered a preferred option due to its efficacy as a macrolide antibiotic. It is effective against a range of bacteria, including those that are typically responsible for endocarditis. Additionally, while clarithromycin can cross the placenta, its safety profile in pregnancy is deemed acceptable for certain conditions, making it a viable choice for this population when penicillin is contraindicated due to an allergy.

Amoxicillin is a penicillin and would not be appropriate for someone with a documented allergy to penicillins. Cephalexin, a first-generation cephalosporin, has some cross-reactivity with penicillin allergies, and thus caution is warranted when considering it for a patient with a penicillin hypersensitivity history. Ciprofloxacin, a fluoroquinolone, is not recommended during pregnancy due to potential adverse effects on fetal development. Therefore, clarithromycin stands out as the most suitable antibiotic in this scenario.