Antibiotic prophylaxis in patients with joint prostheses

Abstract

A systematic literature review was carried out in order to formulate a new Dutch guideline regarding policies for patients with a joint prosthesis who are to undergo a dental procedure. The research question was: Is antibiotic prophylaxis indicated in patients with a joint prosthesis who undergo dental procedures? The literature comprised studies in which patients with joint prostheses underwent a dental procedure resulting in hematogenous periprosthetic joint infection or in which a correlation between prophylactic antibiotics and hematogenous periprosthetic joint infection were described. The GRADE/AGREE II method was used to determine the strength of the evidence. A supplementary review of literature to gain further insight into pathophysiology, risk factors and risk intervention was carried out. The included studies did not provide any conclusive evidence that the use of antibiotic prophylaxis reduces the incidence of dental hematogenous periprosthetic joint infection. The results of the supplementary review of literature also supported the conclusion that antibiotic prophylaxis should be discouraged in dental procedures.