What are the AAOS-ADA joint recommendation for infective endocarditis (IE) prophylaxis prior to performing orthopedic implants or dental procedures?

Updated: Jul 28, 2020
  • Author: Vinh Q Nguyen, MD, FACC; Chief Editor: Buck Christensen  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. [4] The recommendation proposes that the practitioner consider discontinuing 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 unconvincing evidence. The previous guideline from 2003 was updated in 2009 and endorsed antibiotic prophylaxis before dental procedures in all patients with prosthetic joints, with no 2-year time limit. [5] The 2009 guideline position had been criticized for excessive and unwarranted antibiotic use. [6] Furthermore, the 2014 expert panel developed an evidenced-based guideline that does not recommend prophylactic antibiotics prior to dental procedures to prevent prosthetic joint infection. [7]

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


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