Famous scene from "The Matrix" that has no direct association with Antibiotic Prophylaxis to preventing Prosthetic Joint Infections. I feel that the topic of using antibiotic prophylaxis (ABP, AKA prophylactic antibiotic) to prevent prosthetic joint infections (PJIs) is an important matter that affects many of my patients, and it is difficult to explain everything in detail in a realistic clinical setting and to assume proper understanding in such a short encounter. So, I decide to create this relevant post that my patients can read at their leisure... or better yet, ask their physician to come read the referenced article (see below).
I must declare upfront that my position must be based on the recommendation of American Dental Association (ADA) because it is based on the most current and recent researches, that by no means can I do these researches in my practice or spare time. Medicine should be practiced based on evidence, and when there is a conflict between conventional practice and new evidence, one should have an open mind to consider the new recommendations that are based on new evidence.
According to the current research, there is "no evidence that [dental-related] bacteremias are related to prosthetic joint infections." Therefore, for most dental patients with a prosthetic joint, ABP are "not indicated before dental procedures to prevent PJIs." Orthopedic surgeons should consider prophylactic antibiotic only if patient has serious health issues or previous complications related to prosthetic joint surgery. Thus, you still must consult with your orthopedic surgeon, but if your orthopedic surgeon insists that you need antibiotic prophylaxis to prevent PJIs, courteously ask him/her to read the referenced article (see below).
As of today, this is the most current and authoritative article regarding ABP to preventing PJIs.
Link to article
Link to full text
Link to PDF
Reference:
Meyer, D. DDS (2015). Providing clarity on evidence-based prophylactic guidelines for prosthetic joint infections. The Journal of the American Dental Association, 146(1), 3-5. doi: http://dx.doi.org/10.1016/j.adaj.2014.11.009
I must declare upfront that my position must be based on the recommendation of American Dental Association (ADA) because it is based on the most current and recent researches, that by no means can I do these researches in my practice or spare time. Medicine should be practiced based on evidence, and when there is a conflict between conventional practice and new evidence, one should have an open mind to consider the new recommendations that are based on new evidence.
According to the current research, there is "no evidence that [dental-related] bacteremias are related to prosthetic joint infections." Therefore, for most dental patients with a prosthetic joint, ABP are "not indicated before dental procedures to prevent PJIs." Orthopedic surgeons should consider prophylactic antibiotic only if patient has serious health issues or previous complications related to prosthetic joint surgery. Thus, you still must consult with your orthopedic surgeon, but if your orthopedic surgeon insists that you need antibiotic prophylaxis to prevent PJIs, courteously ask him/her to read the referenced article (see below).
As of today, this is the most current and authoritative article regarding ABP to preventing PJIs.
Link to article
Link to full text
Link to PDF
Reference:
Meyer, D. DDS (2015). Providing clarity on evidence-based prophylactic guidelines for prosthetic joint infections. The Journal of the American Dental Association, 146(1), 3-5. doi: http://dx.doi.org/10.1016/j.adaj.2014.11.009
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