Browse by author
Lookup NU author(s): Emeritus Professor Robin Seymour, Professor John Whitworth
Full text for this publication is not currently held within this repository. Alternative links are provided below where available.
Objectives: To provide a critical review of the current evidence that implicates dental-induced bacteraemia as a risk for joint infections in patients fitted with joint prostheses and appraise the need for antibiotic prophylaxis. Design: Retrospective analysis. Setting: Mainly hospital-based patients or subjects. Outcome measures: The relationship between joint infections and dental treatment is equivocal at the best and there is no evidence that antibiotic prophylaxis provides such patients with any protection. Results: Microbiological evidence linking dental treatment-induced bacteraemia to joint infections is weak and if an oral commensal is implicated, it is more likely to have arisen either from a spontaneous bacteraemia or from a dental infection. As a consequence of the latter, we recommended the institution of good dental health prior to joint replacement. There may be a case for providing prophylaxis to the immuno-compromised patient, but only if the immuno-suppression is associated with a neutropenia. In such circumstances, only emergency treatment should be considered until the neutropenia is resolved. Antibiotic regimens that are recommended by orthopaedic surgeons have not been evaluated in a randomised placebo-controlled study and many of the drugs are not licensed for this purpose. The evidence on cost-risk benefit seems to demonstrate that antibiotic prophylaxis with either amoxicillin or penicillin is not cost effective when compared with no prophylaxis. Conclusion: The case for providing antibiotic prophylaxis prior to dental treatment in patients fitted with a joint prosthesis is weak or virtually non-existent. Furthermore, the risk from providing prophylaxis is greater than the risk of a joint infection.
Author(s): Seymour RA, Whitworth JM, Martin M
Publication type: Review
Publication status: Published
Journal: British Dental Journal
Year: 2003
Volume: 194
Issue: 12
Pages: 649-653
ISSN (print): 0007-0610
ISSN (electronic): 1476-5373
URL: http://dx.doi.org/10.1038/sj.bdj.4810352
DOI: 10.1038/sj.bdj.4810352
PubMed id: 12830173
