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New guidelines addressing antibiotics and prosthetic joints in January JADA

December 03, 2014

By Jean Williams

The January issue of The Journal of the American Dental Association will feature updated ADA guidelines regarding the indication for antibiotic prophylaxis prior to dental treatment in patients with prosthetic joints.
A 2014 panel of experts, tasked by ADA Council on Scientific Affairs, developed the ADA guidelines, "The Use of Prophylactic Antibiotics Prior to Dental Procedures in Patients with Prosthetic Joints: Evidence-Based Clinical Practice Guideline for Dental Practitioners." This panel updated the systematic review that was the base of "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.
Dentists should note that there does not appear to be conflict between the updated ADA prosthetic joint infection 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 2014 panel. "They have different risk factors. The microorganisms involved in PJIs are from different ecosystems than the oral cavity whereas those in infective endocarditis can be from the mouth."
The bottom line in this case, said Dr. Sollecito, is that dentists should view the new English study as focusing on a different, unrelated condition than the updated ADA guidelines for treating dental patients with prosthetic joints.