Antibiotic Prophylaxis for Prosthetic Joint Patients Undergoing Invasive Dental Procedures: Time for a Rethink?

被引:8
作者
Springer, Bryan D. [1 ,2 ]
Baddour, Larry M. [3 ,4 ]
Lockhart, Peter B. [5 ]
Thornhill, Martin H. [5 ,6 ]
机构
[1] OrthoCarolina Hip & Knee Ctr, Charlotte, NC USA
[2] Atrium Musculoskeletal Inst, Charlotte, NC USA
[3] Mayo Clin, Coll Med, Div Infect Dis, Dept Med, Rochester, MN USA
[4] Mayo Clin, Coll Med, Div Infect Dis, Dept Cardiovasc Dis, Rochester, MN USA
[5] Carolinas Med Ctr Atrium Hlth, Dept Oral Med, Charlotte, NC USA
[6] Univ Sheffield, Sch Clin Dent, Unit Oral & Maxillofacial Med Surg & Pathol, Sheffield, S Yorkshire, England
关键词
arthroplasty; infection; antibiotic prophylaxis; dental procedures; guidelines; prevention; INFECTIVE ENDOCARDITIS; TOTAL HIP; KNEE ARTHROPLASTY; ADVERSE-REACTIONS; ECONOMIC-IMPACT; OLMSTED COUNTY; RISK-FACTORS; BACTEREMIA;
D O I
10.1016/j.arth.2022.02.014
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background: In the United States, it has been common practice to recommend that dentists provide antibiotic prophylaxis (AP) before invasive dental procedures (IDPs) to prevent late periprosthetic joint infections (LPJIs) in patients who have prosthetic arthroplasties 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-month period prior to LPJI hospital admissions in the United Kingdom 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 IDPs and LPJI should be fully exposed. Results: No significant positive association was identified between IDPs and LPJI. Indeed, the incidence of IDPs was lower in the 3 months before LPJI hospital admission than that in the preceding 12 months. Conclusion: In the absence of a significant positive association between IDPs and LPJI, there is no rationale to administer AP before IDPs in patients with prosthetic joints, particularly given the cost and inconvenience of AP, the risk of adverse drug reactions, and the potential for unnecessary AP use that promotes antibiotic resistance. These results should reassure orthopedic surgeons and their patients that dental care of patients who have prosthetic joints should focus on maintaining good oral hygiene rather than on recommending AP for IDPs. Moreover, it should also reassure those in other countries where AP is not recommended that such guidance is sufficient. (c) 2022 Elsevier Inc. All rights reserved.
引用
收藏
页码:1223 / 1226
页数:4
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