Contents

Search

prophylaxis for prosthetic joint

Indications: antibiotic prophylaxis for dental procedures in patients with prosthetic joints - no clear data to support antibiotic prophylaxis for dental procedures [2,3,4,5,6] - joint replacement in the past 2 years or those prone to infections* a) type 1 diabetes b) cancer c) HIV1 infection d) immunosuppressants [1] - American Academy of Orthopaedic Surgeons [4] presents a bewildering assortment of non-evidence based recommendations * recommendations may be outdated Management: - one dose of amoxicillin 2 g... or clindamycin 600 mg for patients allergic to penicillin one hour prior to dental procedure

General

antibiotic prophylaxis

References

  1. Prescriber's Letter 14(7): 2007 Antibiotic Prophylaxis for Dental Patients with Prosthetic Joints Detail-Document#: 230705 (subscription needed) http://www.prescribersletter.com
  2. Berbari EF et al Dental procedures as risk factors for prosthetic hip or knee infection: A hospital-based prospective case-control study. Clin Infect Dis 2010 Jan 1; 50:8 PMID: 19951109 - Zimmerli W and Sendi P Antibiotics for prevention of periprosthetic joint infection following dentistry: Time to focus on data. Clin Infect Dis 2010 Jan 1; 50:17. PMID: 19951108
  3. Journal Watch, April 25, 2012 Massachusetts Medical Society http://www.jwatch.org - American Academy of Orthopedic Surgeons American Dental Association Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures. Evidence-Based Guideline and Evidence Report. http://www.aaos.org/research/guidelines/PUDP/PUDP_guideline.pdf (corresponding NGC guideline withdrawn Nov 2017)
  4. Brett AS Antibiotic Prophylaxis Before Dental Procedures in Patients with Orthopedic Implants. NEJM Journal Watch. March 9, 2017 Massachusetts Medical Society (subscription needed) http://www.jwatch.org - Quinn RH, Murray JN, Pezold R et al. The American Academy of Orthopaedic Surgeons appropriate use criteria for the management of patients with orthopaedic implants undergoing dental procedures. J Bone Joint Surg Am 2017 Jan 18; 99:161 PMID: 28099307 http://insights.ovid.com/crossref?an=00004623-201701180-00010
  5. Thornhill MH, Crum A, Rex S et al Analysis of Prosthetic Joint Infections Following Invasive Dental Procedures in England. JAMA Netw Open. 2022;5(1):e2142987. Jan 19. PMID: 35044470 Free article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2788219
  6. Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2023