Prophylactic Antibiotics Not Needed Before Invasive Dental Procedures

There is no evidence to support administering antibiotic prophylaxis before invasive dental procedures (IDP) in patients with prosthetic joints, according to a study published online Jan. 19 in JAMA Network Open.

Martin H. Thornhill, M.B.B.S., Ph.D., from University of Sheffield School of Clinical Dentistry in the United Kingdom, and colleagues assessed associations between IDP and subsequent late prosthetic joint infection (LPJI) using data from England, where antibiotic prophylaxis has never been recommended to prevent LPJI. The analysis included 9,427 patients admitted to hospitals in England for LPJI between Dec. 25, 2011, and March 31, 2017.

The researchers found that 25.3 percent had hip prosthetic joints, 33.6 percent had knee prosthetic joints, 2.8 percent had other prosthetic joints, and 38.4 percent had unknown prosthetic joint types. There was no significant temporal association observed between IDP and subsequent LPJI. In fact, there was a lower incidence of IDP observed in the three months prior to LPJI (incidence rate ratio, 0.89).

"These findings refute recommendations to give antibiotic prophylaxis to patients with prosthetic joints prior to IDP, given the cost, adverse drug reaction risk, and potential for promoting antibiotic resistance associated with antibiotic prophylaxis," the authors write.