Suscribirse

Antibiotic prophylaxis to reduce the risk of joint implant contamination during dental surgery seems unnecessary - 06/12/12

Doi : 10.1016/j.otsr.2012.07.013 
L. Legout a, b, , c , E. Beltrand c, d, H. Migaud a, c, e, E. Senneville a, b, c
a Lille Nord-de-France University, 59000 Lille, France 
b University Infectious Diseases and Travelers Department, Dron Hospital, rue du Président-Coty, 59208 Tourcoing, rue du Président-Coty, 59208 Tourcoing, France 
c G4 Lille-Tourcoing Osteo-articular Infection Reference Center, Salengro Hospital, Lille Regional University Hospital Center, rue Émile-Laine, 59037 Lille, France 
d Orthopedics-Traumatology Department, Dron Hospital, rue du Président-Coty, 59208 Tourcoing, France 
e University Orthopedics and Traumatology Department Salengro Hospital, Lille Regional University Hospital Center, rue Émile-Laine, 59037 Lille, France 

Corresponding author. Tel.: +33 32 069 4591; fax: +33 32 069 4496. Service de Médecine, Hôpital Dron, 135, rue President-Coty, Tourcoing, France.

Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
Artículo gratuito.

Conéctese para beneficiarse!

Summary

Introduction

Joint implant infection rates range between 0.5% and 3%. Contamination may be hematogenous, originating in oro-dental infection and, as in endocarditis, antibiotic prophylaxis has been recommended to cover oro-dental surgery in immunodepressed patients with joint implants less than 2years old, despite the lack of any formal proof of efficacy. In this context, the cost and side effects of such prophylaxis raise the question of its real utility.

Materials and methods

A search of Pubmed was performed using the following keywords: prosthetic joint infection, dental procedure, antibiotic prophylaxis, hematogenous infection, dental infection, bacteremia, and endocarditis. Six hundred and fifty articles were retrieved, 68 of which were analyzed in terms of orthopedic prosthetic infection and/or endocarditis and oro-dental prophylaxis, as relevant to the following questions: frequency and intensity of bacteremia of oro-dental origin, frequency of prosthetic joint infection secondary to dental surgery, and objective efficacy of antibiotic prophylaxis in dental surgery in patients with joint implants.

Results

Bacteremia of oro-dental origin is more frequently associated with everyday activities such as mastication than with tooth extraction. Isolated cases of prosthetic contamination from dental infection have been reported, but epidemiological studies in joint implant bearers found that absence of antibiotic prophylaxis during oro-dental surgery did not increase the rate of prosthetic infection. The analysis was not able to answer the question of the efficacy of dental antibiotic prophylaxis in immunodepressed patients; however, oro-dental hygiene and regular dental treatment reduce the risk of prosthetic infection by 30%.

Discussion and conclusion

The present update is in agreement with the conclusions of ANSM expert group, which advised against antibiotic prophylaxis in oro-dental surgery in implant bearers, regardless of implant duration or comorbidity: the associated costs and risks are disproportional to efficacy.

Level of evidence and type of study

Level V; expert opinion.

El texto completo de este artículo está disponible en PDF.

Keywords : Dental infection, Dental prophylaxis, Prosthetic joint infection, Amoxicillin, Total joint replacement


Esquema


© 2012  Publicado por Elsevier Masson SAS.
Añadir a mi biblioteca Eliminar de mi biblioteca Imprimir
Exportación

    Exportación citas

  • Fichero

  • Contenido

Vol 98 - N° 8

P. 910-914 - décembre 2012 Regresar al número
Artículo precedente Artículo precedente
  • Percutaneous fixation of thoracolumbar fractures: Current concepts
  • C. Court, C. Vincent
| Artículo siguiente Artículo siguiente
  • Salvage technique for postoperative infection and necrosis of the Achilles tendon
  • E. Fourniols, J.-Y. Lazennec, M.-A. Rousseau

Bienvenido a EM-consulte, la referencia de los profesionales de la salud.

Mi cuenta


Declaración CNIL

EM-CONSULTE.COM se declara a la CNIL, la declaración N º 1286925.

En virtud de la Ley N º 78-17 del 6 de enero de 1978, relativa a las computadoras, archivos y libertades, usted tiene el derecho de oposición (art.26 de la ley), el acceso (art.34 a 38 Ley), y correcta (artículo 36 de la ley) los datos que le conciernen. Por lo tanto, usted puede pedir que se corrija, complementado, clarificado, actualizado o suprimido información sobre usted que son inexactos, incompletos, engañosos, obsoletos o cuya recogida o de conservación o uso está prohibido.
La información personal sobre los visitantes de nuestro sitio, incluyendo su identidad, son confidenciales.
El jefe del sitio en el honor se compromete a respetar la confidencialidad de los requisitos legales aplicables en Francia y no de revelar dicha información a terceros.


Todo el contenido en este sitio: Copyright © 2024 Elsevier, sus licenciantes y colaboradores. Se reservan todos los derechos, incluidos los de minería de texto y datos, entrenamiento de IA y tecnologías similares. Para todo el contenido de acceso abierto, se aplican los términos de licencia de Creative Commons.