Is Antibiotic Pre-treatment Necessary for Hip Replacement Patients?
If you have had a hip replacement, you might wonder whether you should take antibiotics as a precaution against infection (antibiotic prophylaxis). About one in 100 arthroplasty patients develop a prosthetic joint infection (PJI), and the effects can create serious complications. The debate continues over what role oral bacteria play in creating serious conditions like bacteremia and whether dentists should use antibiotic prophylaxis on total joint arthroplasty patients.
Studies offer conflicting information, but the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association have jointly developed guidelines for antibiotic pre-treatment to reduce the risk of post-surgical infection. They focus on some at-risk and immune-compromised patients.
The AAOS acknowledges that the chance of oral bacteria causing joint infection is “extremely low,” but because the consequences of infection can be devastating, the organization gives physicians discretion in prescribing prophylactic antibiotics before dental work.
If it has been more than 18 months after a routine arthroplasty, there appears to be little to no need to pre-treat before a dental procedure.
If you have had a total hip replacement, talk to your general practitioner or your orthopedic surgeon about whether you should ask for antibiotics before visiting the dentist.
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