Antibiotic prophylaxis for dental treatment after prosthetic joint replacement: exploring the orthopaedic surgeon's opinion

Arthroplast Today. 2016 Mar 3;2(3):123-126. doi: 10.1016/j.artd.2015.12.003. eCollection 2016 Sep.

Abstract

Background: Antibiotic prophylaxis before dental treatment is routinely recommended by orthopaedic surgeons to prevent prosthetic joint infection (PJI). This recommendation is at odds with current guidelines.

Methods: A postal survey of 9 checkbox or short-answer questions was completed by 633 orthopaedic surgeons.

Results: The majority of respondents (n = 186 of 260, 72%) believe that antibiotic prophylaxis is required indefinitely for dental treatment. A small number (n = 43, 15%) seek a dentist's opinion before elective joint replacement. The surgeons reported low numbers of PJIs, although 24% (n = 68 of 280) believed that they were associated with dental treatment.

Conclusions: Australian orthopaedic surgeons continue to recommend antibiotic prophylaxis for dental treatment. The recording of PJI in relation to dental procedures into clinical registries would enable the development of consistent guidelines between professional groups responsible for the care of this patient group.

Keywords: Antibiotic prophylaxis; Arthroplasty; Bacteremia; Dental care; Orthopaedics.