Antibiotic prophylaxis for dental patients with prosthetic joints.

Because of the threat of hematogenous spread of infection arising from invasive dental procedures, preoperative antibiotic prophylaxis should be considered for patients who are endoprostheses recipients. No universally accepted protocol exists to guide practitioners in determining indications or treatment methods for such patients. To ascertain their recommendations, 264 Indiana orthopaedic surgeons were surveyed and 121, 46%, responded. A high percentage of respondents always or usually recommend preoperative antibiotic prophylaxis for oral surgery, extraction and in the case of acute dental infection for hip arthroplasty patients. A slightly lesser percentage of respondents would premedicate for dental restorations for patients with lesser joint arthroplasties. Eighty-four percent of the respondents chose oral cephalosporin as the preferred antibiotic, but the recommended dosage and duration varied. In the absence of universally accepted protocol, it is recommended that dentists contact their patient's surgeon to determine what the most appropriate measures are for that particular person.