Prophylactic Antibiotics

Studies demonstrated that for prophylaxis against postoperative wound infection, administering antibiotics during only one day after the operation has been equally effective as a two day or longer antibiotic prophylactic regime.

For occasions later on, when you need antibiotic protection during dental surgery and like, usually one dose of antibiotics before the dental and other surgery is sufficient. Ask your surgeon for detailed instructions.

There are also risks connected with the use of antibiotics. One is the development of antibiotic-resistant bacterial strains, another is the development of an allergy to antibiotics.

You can diminish these risks yourself: use the antibiotics only when really necessary, and then use them only during the shortest interval possible.

In 2003 the American Dental Association and American Academy of Ortopaedic Surgeons issued a common statement about the use of prophylactic antibiotics before common dental procedures. These guidelines were usually followed by the most doctors, more because of fear of litigation than because a proven connection between dental procedures and infection of total joints.

Here follows this Statement. Don't forget that it applies on dental procedures on non-infected teeth only. All infections in the mouth and on teeth must be treated vigorously with correct use of antibiotics.

J Am Dent Assoc, 2003 Vol 134, 899.

Your joint replacement, dental procedures and antibiotics
by: American Dental Association, and American Academy of Orthopaedic Surgeons

For the first two years after a joint replacement, all patients may need antibiotics for all high-risk dental procedures. After two years, only high-risk patients may need to receive antibiotics for high-risk procedures.

The bacteria commonly found in the mouth may travel through the bloodstream and settle in your artificial joint. This increases your risk of contracting an infection. Ask your dentist about preventive antibiotics for all dental procedures with a high risk of bleeding or producing high levels of bacteria in your blood. Your dentist and your orthopaedic surgeon, working together, will develop an appropriate course of treatment for you.

You may need preventive antibiotics before all high-risk dental procedures if

– you had a joint replacement less than two years ago.

– you’ve had previous infections in your artificial joint.

– you have an inflammatory type of arthritis, type 1 diabetes or hemophilia.

– you have a suppressed immune system or are malnourished.

– you have a history of prior or present malignancy.

These dental procedures have a high risk of bleeding or producing high levels of bacteria in your blood:

– all dental extractions;

– all periodontal procedures;

– dental implant placement and replantation of teeth that were knocked out;

– some root canal work;

– initial placement of orthodontic bands (not brackets);

– certain specialized local anesthetic injections;

– regular dental cleanings (if bleeding is anticipated).

One of these preventive antibiotics may be prescribed for you:

– if you are not allergic to penicillin: 2 grams of amoxicillin, cephalexin or cephradine (orally) OR 2 grams of ampicillin or 1 gram of cefazolin (intramuscularly or intravenously) 1 hour before the procedure.

– if you are allergic to penicillin: 600 milligrams of clindamycin (orally or intravenously) 1 hour before the procedure.

These guidelines were developed by the American Academy of Orthopaedic Surgeons and the American Dental Association. They are designed to help practitioners make decisions about preventive antibiotics for dental patients with artificial joints. They are not a standard of care or a substitute for the practitioner’s clinical judgment. Practitioners must exercise their own clinical judgment in determining whether or not preventive antibiotics are appropriate. Pediatric doses may be different.

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Your joint replacement, dental procedures and antibiotics by: American Dental Association, and American Academy of Orthopaedic Surgeons

For the first two years after a joint replacement, all patients may need antibiotics for all high-risk dental procedures. After two years, only high-risk patients may need to receive antibiotics for high-risk procedures.

Your joint replacement, dental procedures and antibiotics
by: American Dental Association, and American Academy of Orthopaedic Surgeons