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Posts for tag: Antibiotics

In 2015, the American Dental Association (ADA) published guidelines that advised AGAINST the use of antibiotics prior to dental procedures in patients with orthopedic implants due to the lack of evidence associating dental procedures with prosthetic joint infections (PJIs) and the absence of data supporting a benefit of antibiotics.

Over 1 million hip and knee replacements are performed in the United States each year.  The reported risk of infections ranges from 0.3% to 8.3%.  Although dental procedures may result in transient bacteremia, there is no controlled evidence to suggest an association between bacteremia following dental procedures and prosthetic joint infection. Lingering historical concerns have led to inconsistent practices in giving antibiotics before a dental hygiene visit.  

In an attempt to reconcile practice inconsistencies, the American Academy of Orthopedic Surgeons (AAOS) and the ADA published Appropriate Use Criteria (AUC) for antibiotics prior to dental procedures in patients with orthopedic implants.   In addition, the AAOS/ADA AUC have been translated into an online tool to facilitate antibiotic decision assessment.    

The online AUC tool accounts for 64 clinical scenarios and in most cases (61%) advises AGAINST the use of antibiotics prior to a dental procedure.  In the remaining scenarios antibiotics are deemed reasonable (27%) and only 12% of cases, based on risk factors, such as underlying severe immunosuppression or history of PJI are antibiotics recommended.


The AAOS/ADA inventory is available on the AAOS website  and may be a valuable tool to target those individuals who antibiotics prior to dental procedures is NOT recommended and reduce the burden of unnecessary antibiotic exposure.