A patient needs antibiotic treatment for an artificial valve, culture-positive infective enterococcal endocarditis. His medical history includes severe anaphylactic reaction to penicillin G during the past year. The best approach would be treated with :

**Core Concept**
The question requires knowledge of alternative antibiotic treatment options for patients with penicillin allergy, particularly those with infective endocarditis involving artificial valves.

**Why the Correct Answer is Right**
The patient's severe anaphylactic reaction to penicillin G necessitates the use of alternative antibiotics. For enterococcal endocarditis, vancomycin is a suitable option, especially in cases where the isolate is resistant to penicillin. Vancomycin is effective against enterococci and can be used in patients with a history of penicillin allergy.

**Why Each Wrong Option is Incorrect**
* **Option A:** This option is not provided.
* **Option B:** This option is not provided.
* **Option C:** This option is not provided.
* **Option D:** This option is not provided.

**Clinical Pearl / High-Yield Fact**
When treating patients with a history of penicillin allergy, it's essential to consider alternative antibiotics that are effective against the causative organism. Vancomycin is a reliable option for enterococcal endocarditis, and its use should be guided by local antibiotic resistance patterns and susceptibility testing.

**Correct Answer:** C. Vancomycin

✓ Correct Answer: D. Vancomycin