Antibiotic prophylaxis is the administration of antibiotics to a patient that has the potential of harmful consequences with an episode of bacteremia. The potential for bacteremia is present when there is manipulation of the oral mucosa.
Official guidelines for dental antibiotic prophylaxis are instituted to prevent infective endocarditis and infection of prosthetic joints.
The American Heart Association recommends antibiotic prophylaxis in the following scenarios:
- A prosthetic heart valve or repair of valve with prosthetic material.
- History of prior infective endocarditis
- Cyanotic congenital heart disease that is unrepaired
- Repaired congenital heart defects for the first 6 months
- Repaired congenital heart disease with residual defects
The Association of Orthopaedic Surgeons and the ADA in 2014 after an exhaustive systematic review of available evidence have come to the conclusion that antibiotic prophylaxis is not recommended to prevent prosthetic joint infections. At this moment it is recommended to take into consideration: scientific evidence, the clinician’s experience and the patient’s values.
If antibiotic prophylaxis is appropriate for your patient the following antibiotics and dosing can be used 30-60 min prior to procedure:
- Amoxicillin 2g or 50mg/kg
- Clindamycin 600mg or 20mg/kg
- Azithromycin 500mg or 15mg/kg
Some additional clinical scenarios that may require prophylaxis and should be cleared by the patient’s physician include: renal dialysis shunt, CSF shunt, chemotherapy. When in doubt always check with the patient’s physician, as the patient’s safety is of utmost importance. Dr. Benjamin Yagoubian at Torrance Oral Surgery and Dental Implant Center, has the patient’s safety and comfort as primary concern. Dr. Benjamin Yagoubian takes the time to interview every patient to discuss what is the best method of treatment to ensure a safe environment.