Subject: Antibiotic Prophylaxis for Joint Prostheses Infection
Effective Date: October 2016
Purpose
To protect patients who are at risk for the development of prosthetic joint infection subsequent to dentally-induced bacteremias.
General Policy
The University of Washington School of Dentistry adopts the current recommendations of the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association (ADA) for the prevention of prosthetic joint infection. This policy will automatically adopt any updated guidelines of the ADA and consider the guidelines of the AAOS when they are published.
Implementation
I. Patients who are at risk for prosthetic joint infection shall be treated using the current AAOS and ADA guidelines for the prevention of prosthetic joint infection unless a significant medical reason documented by the patient’s physician or health care provider (including the attending dentist) exists for deviating from this policy.
Previously in patients with joint prosthesis, AAOS recommended antibiotic prophylaxis but the AAOS recently changed their recommendations to be in line with the ADA. The practice of giving patient’s antibiotics prior to a dental procedure is NOT recommended EXCEPT for patients with the highest risk of adverse outcomes, such as those with a history of prosthetic infections, active, known diabetics, those with an HbA1c above 8.0/blood glucose > 200, or immunocompromising medical conditions (see “Indication Profile” on next page.)
See: AAOS: http://www.orthoguidelines.org/guideline-detail?id=1021
ADA: http://www.ada.org/~/media/EBD/Files/ADA_Chairside_Guide_Prosthetics.pdf?la=en
Full Evidence-Based Report: Need new link
II. Primary regimes for dental procedures are listed in an online decision support application: http://www.orthoguidelines.org/go/auc/default.cfm?auc_id=224995&act ionxm=Terms
Reference:
Ortho Guidelines – American Academy of Orthopaedic Surgeons – Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures. Copyright 2016. 9400 W. Higgins Road, Rosemont, IL 60018.
Dean of UW SOD:
Joel Berg, Dean of the UW School of Dentistry