What is the appropriate prophylaxis for a patient allergic to penicillin who has GBS?

In cases where a patient has a Group B Streptococcus (GBS) infection and is allergic to penicillin, the choice of prophylactic antibiotic is crucial for effective management while avoiding an allergic reaction. The appropriate prophylaxis in such scenarios is typically vancomycin.

Vancomycin is a glycopeptide antibiotic that is effective against Gram-positive bacteria, including resistant strains of staphylococci and streptococci. It is often used in patients who have severe penicillin allergies because of its broad-spectrum activity and safety profile in these populations. While some alternatives exist, vancomycin is widely recommended for its ability to cover GBS and its compatibility with individuals who cannot tolerate penicillin.

The other antibiotics listed may not be the best choice in this scenario. For example, clindamycin is an alternative but may not cover all GBS strains, especially those that are resistant. Cefazolin is a cephalosporin and carries a risk of cross-reactivity in patients with penicillin allergies. Azithromycin, while effective against certain bacteria, generally does not provide reliable coverage for GBS and is not typically used as the first-line prophylactic agent in this context.

Thus, vancomycin stands out as