Joint Replacement Infection Precautions

Antibiotic prophylaxis is not indicated for patients with pins/plates and screws. In all situations, discuss your condition with the treating physician and inform him/her of your orthopaedic implant.

It is recommended for:

1. All patients after prosthetic joint replacement for the first two years.
2. For Immunocompromised/immunosuppressed patients (Rheumatoid arthritis, Lupus, HIV, Malnourishment, Diabetes, Malignancy, Previous Prosthetic Infection, Hemophilia), prophylaxis is recommended for the life of the patient.
3. Any dental procedure which may create significant bleeding:
Extractions
Dental Implantation
Periodontal procedure
Root canals
Cleaning if bleeding is anticipated
Discuss with your dentist if bleeding is anticipated

If not allergic to Penicillin:
Cephalexin, cephradine, or amoxicillin 2 grams orally one hour prior to dental procedure.

If Unable to take oral medications:
Ancef onegram or Ampicillin 2 grams IM/IV one hour prior to procedure

If allergic to Penicillin:
Clindamycin 600mg orally one hour prior to procedure. If unable to take oral medications: Clindamycin 600 mg IV one hour prior to procedure

4. Urology procedures: Ask your Urologist to give alternative antibiotics based on the specific organisms that you might be exposed to.
Any kidney stone manipulation (includes shock wave treatment)
Endoscopic procedures
Transrectal prostate biopsy
Indwelling catheter or intermittent catheterization
Indwelling uretral stent
Urinary retention

Ciproflaxacin 500 mg or Levofloxacin 500 mg or Ofloxacin 400mg orally one hour prior to procedure

Ampicillin 2 grams IV (or Vancomycin 1 gram IV, if penicillin allergic) with gentamicin 1.5 mg/kg IV 30 minutes before procedure.



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