Premedication No Longer Recommended For Most Joint Replacement Patients
A New Evidence-Based Clinical Practice Guideline on the Use of Prophylactic Antibiotics in Patient with Prosthetic Joints
A Report from the American Dental Association Council on Scientific Affairs has determined that the use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints is no longer warranted for most people.
In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection.
Clinical Reasoning for the Recommendation:
- There is evidence that dental procedures are not associated with prosthetic joint implant infections
- There is evidence that antibiotics provided before oral care do not prevent prosthetic joint implant infections
- There are potential harms of antibiotics including the risk for anaphylaxis, antibiotic resistance, and opportunistic infections like Clostridium difficile
- The benefits of antibiotic prophylaxis may not exceed the harms for most patients
- The individual patient's circumstances and preferences should be considered when decided whether to prescribe antibiotics prior to dental procedures