Total hip replacement and antibiotics

AATHA-Fig14In the most recent edition of the JADA there was an article referring to the indiscriminate use of antibiotics in patients with prosthetic joints, before dental treatments.

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Results: ” A strategy of foregoing antibiotic prophylaxis before dental visits was cost-effective and resulted in lower lifetime accumulated costs ($11,909) and higher accumulated quality-adjusted life years (QALYs) (12.375) when compared with alternative prophylaxis strategies.”

Conclusions.”The results of Markov decision modeling indicated that a no-antibiotic prophylaxis strategy was cost-effective for dental patients who had undergone Total Hip replacement.  These results support the findings of case-control studies and the conclusions of an American Dental Association Council on Scientific Affairs report that questioned general recommendations for antibiotic prophylaxis before dental procedures.”

Interestingly, they found that clindamycin, that notoriously has such a bad reputation for causing adverse effects such as diarrhea, actually caused less adverse effects when as compared to Amoxcillin!  This has also my been my personal experience as well, with amoxcillin causing more issues in my patients as compared with the use of clindamycin.File Nov 14, 08 37 48