McMaster University

McMaster University

Early Manuscript Release

Published: December 12, 2013
MacOrtho is pleased to showcase an early release of the Hamilton Arthroscopy Group manuscript entitled “Antibiotic Prophylaxis for Dental Procedures at Risk of Causing Bacteremia Among Post-Total Joint Replacement Patients: A Survey of Canadian Orthopaedic Surgeons and Dental Surgeons” published in the Journal of Arthroplasty.

 

Colterjohn T, de Beer J, Petruccelli D, Zabtia N, Winemaker M. Antibiotic Prophylaxis for Dental Procedures at Risk of Causing Bacteremia Among Post-Total Joint Replacement Patients: A Survey of Canadian Orthopaedic Surgeons and Dental Surgeons. J Arthroplasty

Abstract

To elicit current practice and attitudes toward use of antibiotic-prophylaxis among TJR patients prior to dental procedures, we conducted a cross-sectional survey of practicing Canadian orthopaedic (OS) and dental surgeons (DS). Of respondents, 77% of OS and 71% of DS indicated that they routinely prescribe antibiotic-prophylaxis, but while 63% of OS advocate lifelong use, only 22% of DS choose to do so (p<0.0001). While we concluded that both groups nonetheless recognize the importance of treatment within 2-years post-TJR as per historical AAOS/ADA guidelines, it is important to note that the 2-year recommendation, as cited by the AAOS/ADA to be the most critical period for seeding of bacteremia, was based on results of a single unpublished study which had thus not been subjected to critical peer review.  Results of our study did show that greater duration of practice and hence greater experience pointed to the potential inadequacy of these guidelines based on reported experience with late hematogenous infection. It is very clear that orthopaedic and dental surgeons agree the evidence and current practice guidelines to support decision making regarding antibiotic prophylaxis for TJR patients undergoing dental procedures remains inadequate. The AAOS and ADA admit this weakness in their updated 2012 clinical practice guideline indicating that their grades of recommendation are limited at best due to the lack of evidence in some cases and conflicting evidence in others, ultimately resulting in non-consensus.

For further information, please contact:

Danielle Petruccelli, MLIS, MSc

Research Coordinator, Hamilton Arthroplasty Group

Measurement & Evaluation Specialist, HNHB Regional Joint Assessment Program

Hamilton Health SciencesJuravinski Hospital

711 Concession St., Hamilton, Ontario, Canada L8V 1C3

P: 905-527-4322 x42296

F: 905-389-5617

petrucce@hhsc.ca www.hagrp.com

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