Drug which can used in management of streptococcal endocarditis susceptible to penicillin, but patient developing immediate allergy following penicillin administration

Ans. is 'b' i.e., Vancomycin * Following table depicts the medical treatment of choice in patients with streptococcal endocarditis:Antibiotic Treatment for infective Endocarditis Caused by Common Organisms"OrganismDrug (Dose, Duration)CommentsStreptococciPe nicill i n - susceptible streptococci, S. gallolyticus* Penicillin G (2-3 mU IV q4h for 4 weeks)--* Ceftriaxone (2 g/d IV as a single dose for 4 weeks)* Vancomycin (15 mg/kg IV q I2h for 4 weeks)* Penicillin G (2-3 mU IV q4h) or ceftriaxone (2 g IV qd) for 2 weeks plus Gentamicin or divided into equal doses q8h for 2 weeks)Can use ceftriaxone in patients with nonimmediate penicillin allergy Use vancomvcin in patients with severe or immediate b-lactam allergyAvoid 2-weeks regimen when risk of aminoglycoside toxicity is increased and in prosthetic valve or complicated endocarditisRelatively penicillin - resistant streptococci* Penicillin G (4 mU IV q4h) or ceftriaxone (2 g IV qd) for 4 weeks plus Gentamicindd ( 3mg/kg qd IV or IM, as a single dosee or divided into equal doses q8h for 2 weeks)* Vancomycin0 as noted above for 4 weeksPenicillin alone at this dose for 6 weeks or with gentamicin during initial 2 weeks preferred for prosthetic valve endocarditis caused by streptococci with penicillin MICs of < 0.1 mg/ mLModerately penicillin -resistant streptococci, nutritionally variant organisms, or Gemella morbillorum* Penicillin G (4-5 mU IV q4h) or ceftriaxone (2g IV qd) for 6 weeks plus Gentamicin (3 mg/kg qd IV or IM as a single dosee or divided into equal doses q8h for 6 weeks)Preferred for prosthetic valve endocarditis caused by streptococci with penicillin MICs fo >0.1 mg/mL * Vancomycinc as noted above for 4 weeks--