Springer, B., Baddour, L., Lockhart, P. et al. (1 more author) (2022) Antibiotic prophylaxis for prosthetic joint patients undergoing invasive dental procedures: time for a re-think? Journal of Arthroplasty, 37 (7). pp. 1223-1226. ISSN 0883-5403
Abstract
Background:
In the US, it has been common practice to recommend dentists provide antibiotic prophylaxis (AP) before invasive dental procedures (IDP) to prevent late peri-prosthetic joint infection (LPJI) in patients with prosthetic joints despite lack of evidence for a causal relationship between IDP and LPJI, and a lack of evidence for AP efficacy.
Methods:
A recent study quantified the IDP incidence over the 15-months prior to LPJI hospital-admissions in England for which dental records were available. A case-crossover analysis compared IDP incidence in the 3-months before LPJI admission with the preceding 12-months. The English population was used because guidelines do not recommend AP and any relationship between IDP and LPJI should be fully exposed.
Results:
No significant positive association was identified between IDP and LPJI. Indeed, the incidence of IDP was lower in the 3-months before LPJI hospital admission than in the preceding 12 months.
Conclusions:
In the absence of a significant positive association between IDP and LPJI, there is no rationale to administer AP before IDP in patients with prosthetic joints, particularly given the cost and inconvenience of AP, risk of adverse drug reactions and potential for unnecessary AP use that promotes antibiotic resistance. These results should re-assure orthopaedic surgeons and their patients that dental care of patients with prosthetic joints should focus on maintaining good oral hygiene rather than on recommending AP for IDP. Moreover, it should also re-assure those in other countries where AP is not recommended that such guidance is sufficient.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2022 Elsevier Inc. This is an author produced version of a paper subsequently published in Journal of Arthroplasty. Uploaded in accordance with the publisher's self-archiving policy. Article available under the terms of the CC-BY-NC-ND licence (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
Keywords: | Arthroplasty; infection; antibiotic prophylaxis; dental procedures; guidelines; prevention |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Clinical Dentistry (Sheffield) |
Funding Information: | Funder Grant number NATIONAL INSTITUTES OF HEALTH - UNITED STATES OF AMERICA 1R01DE027917-01 NATIONAL INSTITUTES OF HEALTH - UNITED STATES OF AMERICA 1R01DE027917-01 NATIONAL INSTITUTES OF HEALTH - UNITED STATES OF AMERICA 1R01DE027917-01 |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 08 Feb 2022 15:24 |
Last Modified: | 11 Feb 2023 01:13 |
Status: | Published |
Publisher: | Elsevier |
Refereed: | Yes |
Identification Number: | 10.1016/j.arth.2022.02.014 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:183058 |
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Filename: JOA Accepted Editorial Feb 1st 2022.pdf
Licence: CC-BY-NC-ND 4.0