Print “PDF version”
What’s New in the
Patient Safety World
January 2025
Dental Prophylaxis
in Patients with Prosthetic Joints
The issue regarding use
of prophylactic antibiotics for dental procedures in patients with prosthetic
joints has been controversial. In our July 2019 What's New in the
Patient Safety World column “Dental
Prescribing Called Into Question” we discussed the somewhat ambiguous
wording of previous recommendations that may have led to continued high rates
of prophylactic antibiotics for dental procedures in patients with prosthetic
hips and knees.
The American Academy
of Orthopaedic Surgeons and the American Association
of Hip and Knee Surgeons just issued a limited-strength guideline stating that routine use of a systemic prophylactic antibiotic before a
dental procedure in patients with a hip or knee replacement may not reduce the
risk of a subsequent periprosthetic joint infection.
They cite a limited
number of studies that have shown no difference in infection rates between
those patients who received prophylactic antibiotics for dental procedures and
those who did not. Moreover, they cite the downside of such antibiotic use:
costs, development of antibiotic resistance, and promotion of Clostridioides difficile infection.
They do add that it
is important to recognize there may be other considerations that may lead a
provider to prescribe antibiotics for an individual patient. This decision
should be made with the patient, and the unique risks and benefits for the
patient should be considered.
Hopefully, these new guidelines will reassure dental and orthopedic prescribers that such prescriptions are not necessary in most cases.
References:
American Academy of Orthopaedic Surgeons/American Association of Hip and Knee
Surgeons. Prevention of Orthopaedic Implant Infection
in Patients Undergoing Dental Procedures Evidence-Based Clinical Practice
Guidelines. www.aaos.org/dentalppxcpg Published 11/18/2024 - Approved by the
American Association of Hip and Knee Surgeons on 11/07/2024; Accessed December 19,
2024
https://www.orthoguidelines.org/topic?id=1050&tab=all_guidelines
full guideline
https://www.aaos.org/dentalppxcpg
Print “PDF version”
http://www.patientsafetysolutions.com/
What’s New in
the Patient Safety World Archive