Antibiotic Prophylaxis after Total Joint Replacement
For protection against the remote possibility of blood-borne bacteria during a dental procedure, which could be carried from the mouth to create an infection in a total joint replacement, a combined task force with representatives from the American Academy of Orthopaedic Surgeons and the American Dental Association has made the following guideline recommendations.
- After having a total joint replacement, for the rest of their life, all patients are advised to take an antibiotic regimen for the following dental procedures:
- Prophylactic cleaning of teeth or implants
- Intraligamentary local anesthetic injections
- Periodontal procedures
- Root canal procedures
- Dental extractions
- Dental implant procedures
- Implantation of avulsed teeth
- Initial placement of orthodontic bands
- The recommended antibiotic regimen is:
- For patients not allergic to penicillin antibiotics:
Amoxicillin two (2.0) grams orally one (1) hour prior to the dental procedure.
- For patients with an allergy to penicillin antibiotics, but not to cephalosporin antibiotics:
Cephalexin (e.g. Keflex) or Cephradin two (2.0) grams orally one (1) hour prior to the dental procedure.
- For patients with allergies to both penicillin and cephalosporin antibiotics:
Clindamycin (e.g. Cleocin) 600 mg orally one (1) hour prior to the dental procedure.
- Antibiotic prophylaxis is not warranted for dental procedures for patients with previously placed orthopedic pins, plates or screws (e.g. orthopedic implants that are not joint replacements).
- The above recommendations are considered minimum guidelines. Your doctor and/or dentist are ultimately responsible for making individual treatment recommendations to you based on their clinical judgement.