Rompen J C, Schrier J C M, Walenkamp G H I M, Verheyen C C P M
Isala klinieken, locatie Weezenlanden, afd. Orthopedie en Traumatologie, Postbus 10.500, 8000 GK Zwolle.
Ned Tijdschr Geneeskd. 2008 Oct 18;152(42):2282-6.
Under certain circumstances, patients with a prosthetic joint and a focal infection elsewhere in the body may be at risk of developing bacterial infection of the prosthesis. Patients and physicians should actively prevent infections that can spread systemically. Routine antibiotic prophylaxis is not recommended for all patients with a prosthetic joint and suspected bacteraemia. Antibiotic prophylaxis is warranted in three groups of patients with a prosthetic joint who must undergo an invasive procedure that could cause bacteraemia: patients with a predisposing immunocompromising systemic condition or those receiving immunosuppressive therapy, patients with a dermatological infection, and patients with an obvious focal infection, e.g., urosepsis. If the patient is already receiving antibiotics for the infection, additional prophylaxis is usually unnecessary. For patients undergoing dental procedures who require antibiotic prophylaxis, amoxicillin-clavulanic acid or clindamycin are preferred.
在某些情况下，患有假体关节且身体其他部位存在局灶性感染的患者可能有发生假体细菌感染的风险。患者和医生应积极预防可能发生全身扩散的感染。不建议对所有患有假体关节且疑似菌血症的患者进行常规抗生素预防。对于三组必须接受可能导致菌血症的侵入性手术的假体关节患者，有必要进行抗生素预防：患有易导致免疫功能低下的全身性疾病或正在接受免疫抑制治疗的患者、患有皮肤感染的患者以及患有明显局灶性感染（如尿脓毒症）的患者。如果患者已经因感染正在接受抗生素治疗，通常无需额外进行预防。对于需要抗生素预防的牙科手术患者，首选阿莫西林 - 克拉维酸或克林霉素。
