Is there scientific evidence to support antibiotic prophylaxis in patients with periodontal disease as a means to decrease the risk of prosthetic joint infections? A systematic review

Purpose To re-assess the scientific literature to ascertain if there is scientific evidence to support antibiotic prophylaxis in patients with periodontal disease as a means to decrease the risk of prosthetic joint infections. Introduction Prosthetic joint infections occur in approximately 0.3-2% of patients and, of these, around 6-13% are thought to be caused by oral bacteria. Antibiotic prophylaxis prior to dental procedures as a means to prevent a prosthetic joint infection has been controversial throughout the years. However, it remains unclear to what extent it has a beneficial effect. We do know that bacteraemia of oral origin is directly proportional to any ongoing inflammation or infection, and that a diseased periodontium may act as an entry for bacteria to spread to distant locations, through the bloodstream, and potentially be the cause of distant site infections. Materials and methods Updated literature search using the PubMed (Medline), and the Clarivate Analytics databases, to identify eligible articles since the previous searches up to April 2019 (last 5 years). Results No studies that relate periodontal disease to the development of a prosthetic joint infection were found. Conclusion Currently, there is no evidence to support or exclude the need of antibiotic prophylaxis as a means to decrease the risk of prosthetic joint infections in patients with periodontal disease.