Delta Dental Plans of Michigan, Ohio and Indiana, Okemos, Michigan, USA.
J Am Dent Assoc. 2010 Jun;141(6):667-71. doi: 10.14219/jada.archive.2010.0255.
In February 2009, the American Academy of Orthopaedic Surgeons (AAOS) published an information statement in which the organization "recommends that clinicians consider antibiotic prophylaxis [AP] for all total joint replacement patients prior to any invasive procedure that may cause bacteremia." The leadership of the American Academy of Oral Medicine (AAOM) thought that there was a need to respond to this new statement.
The authors reviewed the literature on this subject as it relates to the AAOS's February 2009 information statement. The draft of the resulting report was reviewed and approved by the leadership of the AAOM and several dentists in North America who have expertise on this subject.
The risk of patients' experiencing drug reactions or drug-resistant bacterial infections and the cost of antibiotic medications alone do not justify the practice of using AP in patients with prosthetic joints.
The authors identified the major points of concern for a future multidisciplinary, systematic review of AP use in patients with prosthetic joints. In the meantime, they conclude that the new AAOS statement should not replace the 2003 joint consensus statement.
Until this issue is resolved, dentists have three options: inform their patients with prosthetic joints about the risks associated with AP use and let them decide; continue to follow the 2003 guidelines; or suggest to the orthopedic surgeon that they both follow the 2003 guidelines.
2009 年 2 月，美国骨科医师学会（AAOS）发布了一份信息声明，该组织“建议所有接受全关节置换术的患者，在任何可能导致菌血症的侵入性操作之前，考虑使用抗生素预防（AP）。”美国口腔医学学院（AAOM）的领导层认为有必要对此新声明作出回应。
作者回顾了与 AAOS 2009 年 2 月信息声明相关的文献。该报告的草稿经过 AAOM 领导层以及北美几位对此主题具有专业知识的牙医的审查和批准。
患者出现药物反应或耐药菌感染的风险以及抗生素药物的成本本身并不能证明在有假体关节的患者中使用 AP 的合理性。
作者确定了未来对假体关节患者使用 AP 进行多学科、系统审查的主要关注点。同时，他们得出结论，新的 AAOS 声明不应取代 2003 年的联合共识声明。
在解决此问题之前，牙医有三种选择：告知有假体关节的患者使用 AP 的相关风险并由他们自行决定；继续遵循 2003 年的指南；或建议骨科医生遵循 2003 年的指南。
