Department of Medicine, Division of Infectious Diseases, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Clin Infect Dis. 2010 Jan 1;50(1):8-16. doi: 10.1086/648676.
The actual risk of prosthetic joint infection as a result of dental procedures and the role of antibiotic prophylaxis have not been defined.
To examine the association between dental procedures with or without antibiotic prophylaxis and prosthetic hip or knee infection, a prospective, single-center, case-control study for the period 2001-2006 was performed at a 1200-bed tertiary care hospital in Rochester, Minnesota. Case patients were patients hospitalized with total hip or knee infection. Control subjects were patients who underwent a total hip or knee arthroplasty but without a prosthetic joint infection who were hospitalized during the same period on the same orthopedic floor. Data regarding demographic features and potential risk factors were collected. Logistic regression was used to assess the association of variables with the odds of infection.
A total of 339 case patients and 339 control subjects were enrolled in the study. There was no increased risk of prosthetic hip or knee infection for patients undergoing a high-risk or low-risk dental procedure who were not administered antibiotic prophylaxis (adjusted odds ratio [OR], 0.8; 95% confidence interval [CI], 0.4-1.6), compared with the risk for patients not undergoing a dental procedure (adjusted OR, 0.6; 95% CI, 0.4-1.1) respectively. Antibiotic prophylaxis in high-risk or low-risk dental procedures did not decrease the risk of subsequent total hip or knee infection (adjusted OR, 0.9 [95% CI, 0.5-1.6] and 1.2 [95% CI, 0.7-2.2], respectively).
Dental procedures were not risk factors for subsequent total hip or knee infection. The use of antibiotic prophylaxis prior to dental procedures did not decrease the risk of subsequent total hip or knee infection.
牙科手术导致人工关节感染的实际风险以及抗生素预防的作用尚未确定。
为了研究行或不行抗生素预防的牙科手术与人工髋关节或膝关节感染之间的关联，明尼苏达州罗彻斯特市 1200 床的三级护理医院于 2001 年至 2006 年进行了一项前瞻性、单中心、病例对照研究。病例患者为因全髋关节或全膝关节感染而住院的患者。对照组患者为同期同一骨科病房内接受全髋关节或全膝关节置换术但无人工关节感染的患者。收集了有关人口统计学特征和潜在危险因素的数据。使用逻辑回归评估变量与感染几率的关联。
共纳入 339 例病例患者和 339 例对照患者。与未行牙科手术的患者（校正比值比[OR]，0.6；95%置信区间[CI]，0.4-1.1）相比，未接受抗生素预防的行高风险或低风险牙科手术的患者发生人工髋关节或膝关节感染的风险并未增加（校正 OR，0.8；95% CI，0.4-1.6）。高风险或低风险牙科手术中的抗生素预防并未降低随后发生全髋关节或全膝关节感染的风险（校正 OR，0.9[95% CI，0.5-1.6]和 1.2[95% CI，0.7-2.2]）。
牙科手术不是随后发生全髋关节或全膝关节感染的危险因素。在牙科手术前使用抗生素预防并不能降低随后发生全髋关节或全膝关节感染的风险。
