What is the best pre-surgical antibiotic protocol for a penicillin allergic patient?

For a patient with a penicillin allergy, the best pre-surgical antibiotic protocol focuses on providing effective coverage while avoiding penicillins or their derivatives. Clindamycin is a preferred antibiotic in such cases because it is effective against common oral pathogens and has good tissue penetration, particularly in dental procedures.

The protocol involving 600 mg of clindamycin administered one hour pre-operatively ensures that the antibiotic reaches effective serum levels prior to the surgical intervention, thus minimizing the risk of postoperative infections. Following this, a continuation with 300 mg tid for one day helps maintain adequate therapeutic levels, ensuring ongoing protection against possible infections during the critical period after surgery.

This option is superior to other antibiotics listed, as it specifically addresses the need for an alternative in penicillin-allergic patients while providing the necessary coverage to prevent infection in a surgical setting. The dosing schedule is also practical, balancing efficacy with the need for patient compliance and administration routes.