New American Academy of Orthopaedic Surgeons (AAOS) criteria specify when it may be appropriate to consider antibiotic administration prior to various dental procedures to prevent infection of orthopaedic replacement joints or implants. “Appropriate Use Criteria (AUC) for the Management of Patients with Orthopaedic Implants Undergoing Dental Procedures” was recently approved by the AAOS Board of Directors.
Most patients with replacement hip, knee, shoulder or other implants, are not at risk for infection following dental procedures. However, there are a small number of patients—those with severely compromised immune systems due to AIDS, uncontrolled diabetes or chemotherapy; a recent history of joint infections; and/or patients taking specific drugs for rheumatoid arthritis or to prevent organ transplant complications—who should receive consideration for antibiotic administration prior to dental procedures. In these patients, infection may occur during the procedure when bacteria travel through the blood stream to the implant, which cannot fight off disease or infection. A severe infection will most likely require surgery at the site of the implant infection, and may even cause death.
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