It is very important for total joint replacement patients to remember that bacteria in your blood stream can get into your artificial joint and cause infection. If you get an infection in your teeth, sinuses, throat, bladder, feet or any place else, it must be treated. You will always need antibiotic coverage when you have dental work, endoscopy procedures, flexible sigmoidoscopies, or other surgical procedures that may put you at risk for an inflection. You should always tell (and remind) your primary care doctor that you have had a joint replacement.
The American Dental Association and the American Academy of Orthopaedic Surgeons recommend that prophylactic antibiotics be administered to patients who have had total joint replacements prior to any dental work including routine cleaning*. Antibiotics should also be used prior to any urologic manipulation or any procedure which may potentially cause a transient bacteremic state.
Suggested Antibiotic Prophylaxis Regimen (no second doses recommended):
Patients not allergic to Penicillin: use Cephalexin, Cephradine, or Amoxicillin
2 grams given orally 1 hour prior to dental procedure
Patients not allergic to Penicillin and unable to take oral medications: Cefazolin or Ampicillin
Cefazolin 1 gram or Ampicillin 2 grams given intramuscular or intravenously 1 hour prior to dental procedure
Patients allergic to Penicillin: Clindamycin
600 milligrams given orally 1 hour prior to dental procedure
Patients allergic to Penicillin and unable to take oral medications: Clindamycin
600 milligrams given intravenously 1 hour prior to dental procedure
*JADA, Vol. 128, July 1997