Bay Area Oral & Facial Surgery
Oral & Facial Surgery
San Francisco CA
415-392-3122

Joint Replacement Prophylaxis

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We monitor our contact requests several times a day and will usually reply within one business day during open hours.

Patients at Potential Increased Risk of Experiencing
Hematogenous Total Joint Infection

PATIENT TYPECONDITION PLACING PATIENT AT RISK
All patients during first two years following joint replacementNot Applicable
Immunocompromised or immunosuppressed patientsInflammatory arthropathies such as rheumatoid arthritis
Systemic lupus erythematosus
Drug- or radiation-induced immunosuppression
Patients with comorbiditiesExamples are:
Previous prosthetic joint infections
Malnourishment
Hemophilia
HIV infection
Insulin-dependent diabetes
Malignancy

Incidence Stratification of Bacteremic Dental Procedures

INCIDENCEDENTAL PROCEDURE
Higher incidenceDental extractions
Periodontal procedures, including surgery, subgingival placement of antibiotic fibers/strips, scaling and root planing, probing, recall maintenance
Dental implant placement and replantation of avulsed teeth
Endodontic (root canal) instrumentation or surgery beyond the apex
Initial placement of orthodontic bands but not brackets
Intraligamentary and intraosseous local anesthetic injections
Prophylactic cleaning of teeth or implants where bleeding is anticipated
Lower incidence (prophylaxis not indicated)Restorative dentistry (operative and prosthodontic) with/without retraction cord
Local anesthetic injections (non-intraligamentary and non-intraosseous)
Intracanal endodontic treatment; placement of post and buildup
Placement of rubber dam
Postoperative suture removal
Placement of removable prosthodontic/orthodontic appliances
Taking of oral impressions
Fluoride treatments
Taking of oral radiographs
Orthodontic appliance adjustment

Suggested Drug and Regimen

PATIENT TYPESUGGESTED DRUGREGIMEN (1-dose only)
Patients not allergic to penicillinCephalexin, cephradine or dental amoxicillin2 grams orally 1 hour prior to procedure
Patients not allergic to penicillin and unable to take oral medicationsCefazolin or ampicillinCefazolin 1 g or ampicillin 2 g intramuscularly or intravenously 1 hour prior to dental procedure
Patients allergic to penicillinClindamycin600 milligrams orally 1 hr prior to dental procedure
Patients allergic to penicillin and unable to take oral medicationsClindamycin600 milligrams intravenously 1 hr prior to dental procedure