Strazzeri J C, Anzel S
Clin Orthop Relat Res. 1986 Sep(210):128-31.
Late infection of a total hip arthroplasty after dental extraction has been reported, but never with an organism that is found exclusively in mouth flora. Actinomyces israelii is an organism responsible for dental caries. A 61-year-old woman developed an infected total hip arthroplasty after dental work. She denies ever being instructed to take prophylactic antibiotics by her orthopedic surgeon, by her internist, or by her dentist. Considering the extensive morbidity and potential mortality of an infected hip prosthesis, it is essential that all physicians are aware of the indications for antibiotic prophylaxis following joint arthroplasty. Recommendations for antibiotic prophylaxis for dental manipulation are a loading dose of 2.0 g of penicillin V orally or 1.2 million U of aqueous procaine penicillin G with 1.0 gram of streptomycin given intramuscularly 30 minutes before dental work, followed by four doses of 0.5 g of penicillin V orally every six hours.
已有报道称全髋关节置换术后发生迟发性感染，但从未有过仅在口腔菌群中发现的病原体导致感染的情况。以色列放线菌是一种可导致龋齿的病原体。一名61岁女性在牙科治疗后发生了感染性全髋关节置换。她否认骨科医生、内科医生或牙医曾指示她服用预防性抗生素。鉴于感染性髋关节假体具有严重的发病率和潜在死亡率，所有医生都必须了解关节置换术后抗生素预防的适应证。牙科操作抗生素预防的推荐方案为：在牙科治疗前30分钟口服2.0克青霉素V或肌肉注射120万单位普鲁卡因青霉素G加1.0克链霉素作为负荷剂量，随后每6小时口服4剂0.5克青霉素V。
