What is the antibiotic medication procedure for dental work following total knee replacement? I would like information regarding the medication recommended, the procedures which require pre-medication, and the lenth of time following surgery that it is necessary to premedicate for dental or other medical procedures? Does the orthopedic medical community has guidelines regarding pre-medication? Any information would be greatly appreciated. Sincerely, Judy Quist

-- Judy Quist (Ejquist@aol.com), July 12, 2000

Answers

I suscribe to Medscape.. it is a medical info service. free.. YOu can subscribe at WWW.medscape.com I found the answer to your question on one of its pages. I have a total knee replacement and the dentist wanted me to take antibiotics. My Doctor reluctantly agreed to prescribe some . I later found this statement on the web site.

"Patient has tooth ache and has to see a dentis , his neighbor, who has has a hip replacement, told hem he might nee antibiotics."

Answer... yes, if he also has type 2 diabetes. A joint statement by the American Dental Association and the American Academy of Orthopedic Surgeons concluded that "antibiotic prophylaxis is not indicated for dental patients with pins, plates, screws, not is it rooutinely indicated for most dental patients with total joint replacements." However, imunocompromised/imunosuppessed patients (inflamatory arthrhopathies: rheumatoid arthritis, systemic lupus erythematosus OR Diesease, drug or radiation-induced immunosuppression AND other pattients: Insulin-dependent type 1 diabetics, First2 years following joint replacement, Previous prosthetic joint infections, malnourishment, or Hemophilia.

Suggested Regimens of Prpphylaxis are: Not allergic to penicillin: cephaliexin, ceplhadine or amooxicillin 2 grams orally 1 hour prioor to dental procedure. Not allergic but unable to take orally: cefazolin 1 gram. or ampicillin 2 grams IM?IV 1 hour prior to procedure. Allergic to penicillin: cliddamycin 600 mg orally 1 hour prior to dental procedure. Allergic but unble to take orally: clicamycin 600 mg IM?IV 1 hour prior to procedure.

No second dose are recommended. (copyright 1997 ADA anmd AAOS)

-- Clayton Benner (kleightonb@aol.com), August 24, 2001.