Prophylactic Antibiotics for Dental Procedures in Patients With Prostheses: Is There a Need? A Survey of 163 Surgeons

Introduction:

Infection as an indication for revision has increased to 12% of the total revisions (UK NJR 9^th report). However, it is next to impossible to find out the cause for a delayed prosthetic infection. With increasing number of arthroplasty procedures, is there a need for prophylactic antibiotics in patients with prostheses?

Methods:

At London Knee Meeting 2012, a total of 163 surgeons were asked to take part in a survey. This was to find out if they knew of any existing guidelines for prophylaxis for dental procedures, if there was a need to practice more uniformly, and if they recommend such prophylaxis to their patients routinely. The grade of the surgeon and their experience in years was also noted.

Results:

Among the 163 surgeons who participated, 102 (62.6%) were arthroplasty surgeons.

Of these, 73 (71.5%) were consultants with 3 or more years of experience. For this study, responses from these 102 surgeons were taken into consideration.

Out of the 102 surgeons, only 39 (38%) were aware of AAOS recommendations. However, only 26 (25.5%) felt the need for such prophylaxis, other 37 (36%) were not sure if such prophylaxis was necessary. The remaining 39 (38.5%) did not think the prophylaxis was necessary.

There was no difference found in the responses between the consultant and non-consultant surgeons.

Conclusions:

From this survey, it is clear that there is no uniformity of the knowledge of existing recommendations for prophylaxis of such patients with prostheses. There is probably a need to develop robust guidelines for prophylaxis, given the devastating nature of an infected prosthesis.