title: Antibiotic prophylaxis during dental procedures in patients with in situ lower limb prosthetic joints.
abstract: The average age of patients presenting for total joint arthroplasty is decreasing. The number of primary and revision arthroplasty procedures performed in the UK, Europe and USA is increasing annually. As number of procedures performed increases, the life expectancy of our patients and therefore the in vivo duration of prosthetic joints increase, and the potential for complications such as infection increases. One potential source for this is bacterial dissemination during dental surgery. Many attempts have been made to address this issue in the form of national guidelines, but there is no clear consensus on antibiotic prophylaxis before these procedures in order to decrease the risk of prosthetic joint infection. This continues to be an area of indecision and uncertainty resulting in patients having delays in their treatment while decisions are made by oral and orthopaedic surgeons about prophylactic antibiotic use. This article reviews the existing national guidelines, highlighting the current views and issues surrounding this subject, and a critical appraisal of current evidence for the use of prophylactic antibiotics in this patient population is presented. We will also review the response in literature to the 2009 American Academy of Orthopaedic Surgeons information statement release on antibiotic prophylaxis in joint arthroplasty patients undergoing dental procedures.
authors.affiliation: Department of Trauma and Orthopaedics, Whiston Hospital, Warrington Road. Prescot, Merseyside, L35 5DR, UK.
authors.forename: U
authors.initials: U
authors.lastname: Alao
authors.forename: R
authors.initials: R
authors.lastname: Pydisetty
authors.forename: N A
authors.initials: NA
authors.lastname: Sandiford
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D001315:Australia; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D007720:Knee Prosthesis / Q000009:adverse effects; D019647:Oral Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D017410:Practice Guidelines as Topic; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000517:prevention & control*; D006113:United Kingdom; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents