What is the standard prophylactic antibiotic regimen for IE prevention in a non-allergic patient?

• A. Clindamycin 600 mg PO 30-60 minutes before.
• B. Azithromycin 500 mg PO 1 hour before.
• C. Cephalexin 2 g PO 30-60 minutes before.
• D. Amoxicillin 2 g PO 30-60 minutes before.

Answer: (D)

For a patient who has no penicillin allergy, the standard prophylaxis before a dental procedure is a single oral dose of amoxicillin 2 g taken 30 to 60 minutes beforehand. Amoxicillin is preferred because it has excellent oral bioavailability and rapid absorption, producing sufficient serum and tissue concentrations right when bacteremia can occur during the procedure. This timing helps minimize the risk of infectious organisms seeding heart valves in those at risk. Alternatives exist for those with allergies or intolerance—such as clindamycin, azithromycin, or cephalexin—but they are not the first-line choice in a non-allergic patient.