Dental Procedures as Risk Factors for Prosthetic Hip or Knee Infection: A Hospital‐Based Prospective Case‐Control Study

Berbari, Elie F.; Osmon, Douglas R.; Carr, Alan B.; Hanssen, Arlen D.; Baddour, Larry M.; Greene, Doris; Kupp, Leo I.; Baughan, Linda W.; Harmsen, William S.; Mandrekar, Jayawant N.; Therneau, Terry M.; Steckelberg, James M.; Virk, Abinash; Wilson, Walter R.

doi:10.1086/648676

Cited by 213 publications

(176 citation statements)

References 47 publications

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“…Obesity has been associated with an increased risk of infection in many (9,(17)(18)(19)(20)(21)(22)(23)(24)(25) but not all (26) studies. A body mass index (BMI) threshold of 35 is most commonly used.…”

Section: Risk Factorsmentioning

confidence: 99%

“…This may be due to increased biofilm formation in the presence of elevated levels of glucose, as seen in in vitro models (31); impaired leukocyte function; or microvascular changes in patients with diabetes, which may influence wound healing and the development of superficial surgical site infections. However, not all studies have demonstrated a clear link between diabetes and PJI (17,26), and some studies that have shown an increased risk grouped diabetes mellitus with other immunocompromising conditions (24).…”

Section: Risk Factorsmentioning

confidence: 99%

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Prosthetic Joint Infection

2014

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SUMMARY Prosthetic joint infection (PJI) is a tremendous burden for individual patients as well as the global health care industry. While a small minority of joint arthroplasties will become infected, appropriate recognition and management are critical to preserve or restore adequate function and prevent excess morbidity. In this review, we describe the reported risk factors for and clinical manifestations of PJI. We discuss the pathogenesis of PJI and the numerous microorganisms that can cause this devastating infection. The recently proposed consensus definitions of PJI and approaches to accurate diagnosis are reviewed in detail. An overview of the treatment and prevention of this challenging condition is provided.

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Section: Risk Factorsmentioning

confidence: 99%

Section: Risk Factorsmentioning

confidence: 99%

Prosthetic Joint Infection

2014

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“…[11][12][13] Current evidence suggests that dental procedures play a minor role in the development of infective endocarditis and periprosthetic joint infection. [14][15][16][17][18][19] Increased awareness of antibiotic resistance has also questioned the appropriateness and scope of antibiotic prophylaxis use in dentistry.…”

Section: Introductionmentioning

confidence: 99%

Current prescribing Practices for Antibiotic Prophylaxis: A Survey of Dental Practitioners

Spittle¹,

Muzzin²,

Campbell³

et al. 2017

The Journal of Contemporary Dental Practice

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Aim: Antibiotic prophylaxis guidelines have been developed for health care and dentistry. The authors examined whether dentists were following the 2007 American Heart Association (AHA) and the 2012 American Association of Orthopaedic Surgeons (AAOS) recommendations for antibiotic prophylaxis. Materials and methods:A survey was sent to 600 dentists in the south-central region of the United States. The survey examined dentists' prescribing practices for patients with cardiac and prosthetic joint replacements, antibiotic regimen prescribed, confidence in their prescription decisions, and dentistry's contribution to antibiotic resistance. Results:The response rate was 28.7% (n = 172). Dentists followed the 2007 AHA guidelines for patients with a history of infective endocarditis (95%), and cardiac valves repaired with prosthetic materials (76%) or animal/donor tissue (61%). For prosthetic joint replacement, 72% prescribed antibiotic prophylaxis within the first 2 years after placement and 58% continued to prescribe after 2 years. Amoxicillin was the most frequently prescribed antibiotic for cardiac conditions (92%) and prosthetic joint replacements (77%). No significant differences were found in relation to dentists' gender (p = 0.75), year of graduation (p = 0.71), scope of practice (p = 0.30), and their confidence in their prescription decisions; 73% believed taking multiple doses of antibiotics leads to antibiotic resistance. Conclusion:The majority of dentists were following the 2007 AHA guidelines. Confusion regarding the 2012 AAOS guidelines for prosthetic joint replacement was evident.Clinical significance: Keeping current with changing antibiotic prophylaxis guidelines ensures dentists are providing the best evidence-based dentistry for their patients.

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“…26 This statement issued by the ADA has since been supported by numerous studies that have questioned the use of prophylactic antibiotics in patients with prosthetic joints. A large case-control study by Berbari et al 22 showed that antibiotic prophylaxis before dental procedures was not associated with a decreased risk of prosthetic joint infections and suggested that the 2009 guidelines should be reconsidered. Studies by Matar et al 28 and Skaar et al 29 came to similar conclusions.…”

Section: Dental Proceduresmentioning

confidence: 99%

Antibiotic Prophylaxis for Patients with a History of Total Joint Replacement

DeFroda

Lamin

Gil

et al. 2016

The Journal of the American Board of Family Medicine

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As the population ages and people remain active into the 7th and 8th decades of life, the frequency of total joint replacement is increasing. Following joint replacement surgery, patients inevitably require various invasive procedures as part of their routine health maintenance, including, but not limited to, dental care, colonoscopy, cystoscopy, and cardiac catheterization. There is scant evidence to support the use of periprocedural prophylactic antibiotics in the prevention of late total joint infection. The guidelines for the usage of periprocedural antibiotics have changed as knowledge of the pathophysiology of joint infection has evolved. We review the current recommendations from subspecialty academic organizations regarding antibiotic prophylaxis for patients undergoing routine urologic, gastrointestinal, dental, and cardiac procedures after total joint replacement. (J Am Board Fam Med 2016;29:500 -507.)

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Dental Procedures as Risk Factors for Prosthetic Hip or Knee Infection: A Hospital‐Based Prospective Case‐Control Study

Abstract: 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.

Cited by 213 publications

References 47 publications

Prosthetic Joint Infection

Prosthetic Joint Infection

Current prescribing Practices for Antibiotic Prophylaxis: A Survey of Dental Practitioners

Antibiotic Prophylaxis for Patients with a History of Total Joint Replacement

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