What are the AAOS and ADA recommendations for endocarditis prophylaxis in patients with orthopaedic implants who undergo dental procedures?

Updated: Feb 05, 2018
  • Author: Mary L Windle, PharmD; Chief Editor: Karlheinz Peter, MD, PhD  more...
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Answer

Answer

A clinical practice guideline produced jointly by the American Academy of Orthopaedic Surgeons (AAOS) and the American Dental Association (ADA) was published in April 2013. [2] The recommendation proposes that the practitioner consider changing the long-standing practice of routinely prescribing prophylactic antibiotic for patients with orthopaedic implants who undergo dental procedures. The grade of recommendation is listed as limited, indicating there is unconvincing evidence. The previous guideline from 2003 was updated in 2009 and endorsed antibiotic prophylaxis before dental procedures for all patients with prosthetic joints, with no 2-year time limit. [3] The 2009 guideline position had been criticized for excessive and unwarranted antibiotic use. [4]

For further information on infective endocarditis, see Infective Endocarditis, Pediatric Bacterial Endocarditis, Infectious Endocarditis, and Neurological Sequelae of Infective Endocarditis.


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