Updated Guideline Indicates Preventative Antibiotic Use Not Recommended Prior to Dental Treatment for Most Patients with Prosthetic Joints
January 15, 2015
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CHICAGO — An updated ADA clinical practice guideline, last evaluated in 2012, finds that in general, for patients with prosthetic joint implants, the use of prophylactic antibiotics, or antibiotics administered to prevent the risk of infection, are not recommended prior to dental procedures to prevent prosthetic joint infection (PJIs). The guidance, included in the January issue of The Journal of the American Dental Association (JADA), was created by a panel of experts tasked by the ADA Council on Scientific Affairs.
“The panel found that the current best evidence failed to demonstrate an association between dental procedures and prosthetic joint infection,” said Dr. Thomas Hart, Chair of the ADA Council on Scientific Affairs. “However, this guideline should be integrated with professional judgment and used along with other available, patient-specific data, needs and preferences to determine an evidence-based approach to care.”
Dentists should note that there does not appear to be a conflict between the updated ADA prosthetic joint infection practice guideline and a recent Lancet publication on infective endocarditis. "Prosthetic joint infection and infective endocarditis are different disorders," said Dr. Thomas Sollecito, who is one of nine members of the panel. "They have different risk factors. The microorganisms involved in PJIs are often from different ecosystems than the oral cavity whereas those in infective endocarditis can be from the mouth."
This recommendation clarifies findings in the 2012 guidelines entitled, “Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures: Evidence-based Guideline and Evidence Report,” which a 2012 panel of American Academy of Orthopaedic Surgeons and ADA authors co-developed.
The full recommendation, entitled, "The Use of Prophylactic Antibiotics Prior to Dental Procedures in Patients with Prosthetic Joints: Evidence-Based Clinical Practice Guideline for Dental Practitioners," can be accessed in the January 2015 print edition of JADA and the JADA website.
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