Should patients with total joint replacements receive prophylactic antibiotics before having dental work done?
Controversial. The American Academy of Orthopedic Surgeons (orthopedists) and the American Dental Association (dentists) have recently issued a joint guideline stating there is insufficient evidence to recommend antibiotic prophylaxis for dental procedures in patients who have a history of total joint replacement. Some physicians disagree and use prophylactic antibiotics for at least the first 2 years postoperatively, especially in patients they consider immunosuppressed. The author uses amoxicillin, cephalexin, or cephadrine 2000 mg orally 1 hour before the procedure. If allergic to penicillin, a patient should get clindamycin 600 mg orally 1 hour before the procedure.