Routine use of prophylactic antibiotics is NOT RECOMMEND prior to dental procedures in orthopedic patients with prosthetic joints.

Abx for joints

In the most recent edition of the Journal of American Dental Association (JADA), there has been an update to the 2013 recommendation on antibiotics prophylaxis recommendation for orthopedic patients with prosthetic joints.  In 2013, the American Association of Orthopedic Surgeons (AAOS), in collaboration with the American Dental Association (ADA), published the results of a comprehensive evidence-based, systematic review and clinical practice guideline entitled, “Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures: Evidence-Based Guideline and Evidence Report”  After conducting an extensive review of the published scientific literature, a multidisciplinary expert panel concluded:

“There is no evidence to demonstrate a DIRECT link between dental-procedure-associated bacteremia and infection of prosthetic joints or other orthopaedic implants,” noting, “There is no evidence that dental related bacteremias are related to prosthetic joint infections.”

In this most recent update, they have reaffirmed the same finding and conclusion that: “Prophylactic antibiotics are not recommended prior to dental procedures
to prevent prosthetic joint infection.  The practitioner and patient should consider possible clinical circumstances that may suggest the presence of a significant medical risk in providing dental care without antibiotic prophylaxis, as well as the known risks of frequent or widespread antibiotic use. As part of the evidence-based approach to care, this clinical recommendation should be integrated with the practitioner’s professional judgment and the patient’s needs and preferences.”

Reference: JADA 2015:146(1): 11-16.

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