General Assembly, Prevention, Postoperative Factors: Proceedings of International Consensus on Orthopedic Infections

Arnold, William V.; Bari, Anurag Kumar; Buttaro, Martín; Huang, Ronald; Mirez, Jenrry Pastor; Neira, Inma; Poojary, Aruna; Purtill, James J.; Quevedo, María S; Ricaurte, Julio César García; Scuderi, Giles R.; Thakur, Harshad; Tözün, I. Remzi

doi:10.1016/j.arth.2018.09.067

Cited by 10 publications

(1 citation statement)

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“…(7) In the absence of evidence supporting the role of antibiotic prophylaxis for every TJA patient undergoing dental procedure for a non-infectious cause, the recommendation of the International Consensus Meeting (ICM) is that prophylaxis should be reserved to patients with extensive comorbidities in whom the probability of developing PJI is higher or those with complex reconstructive procedure in whom development of PJI may have more dire consequences. (45)…”

Section: Discussionmentioning

confidence: 99%

Is there a Role for Antibiotic Prophylaxis Prior to Dental Procedures in Patients with Total Joint Arthroplasty? A Systematic Review of the Literature

Slullitel

Oñativia²,

Piuzzi

et al. 2020

J. Bone Joint Infect.

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Abstract. Background: The indication of prophylactic antibiotics prior to dental procedures for non-infected causes in order to reduce the risk of haematogenous periprosthetic joint infection (PJI) remains as controversial. We performed a systematic review of the literature assessing the relationship between PJI and invasive dental procedures and whether there is evidence to support the use of antibiotic prophylaxis.Methods: This review was conducted in accordance with the 2009 Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews were searched for studies focusing on dental procedures after TJA, reporting on PJI as an outcome. The methodological quality was assessed with the Newcastle-Ottawa quality assessment scale for case-control and cohort studies and by the tool proposed by Murad et al. for observational studies.Results: Our systematic literature review yielded 90 individual studies, of which 9 met the inclusion criteria. The overall infection rate ranged from 0.26% to 2.12%. Of these, cases associated with a dental procedure ranged from 0% to 15.9%. Five of the studies described cases in which antibiotic prophylaxis was administered; however, no clear algorithm regarding type and dosage of antibiotic was mentioned. When assessing the methodological quality of the evidence, all studies had an overall low to moderate quality.Conclusion: The current systematic review, mostly composed of low-quality studies, suggests that there is no direct evidence to indicate prophylactic antibiotics prior to dental procedures in patients with TJA. In line with the current guidelines, no prophylaxis should be used on interventions for non-infected causes, except for occasional unusual situations, which can then be judged individually.

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Section: Discussionmentioning

confidence: 99%