Prophylactic antibiotics for patients with artificial joints undergoing oral and dental surgery: necessary or not?

Prophylactic antibiotic cover for certain oral and dental procedures for patients with artificial joints is a controversial issue. This paper examines the evidence supporting the use of antibiotic cover and concludes that routinely, for the majority of patients with artificial joints, it is not justified. Certain medically compromised patients with artificial joints have a slightly increased risk of infection and, under these circumstances, antibiotic prophylaxis may be justified. The antibiotic recommended for this group is cephradine or in the case of penicillin allergy, clindamycin. Preoperative dental fitness is mandatory for all patients who are to receive artificial joints. This information will be of interest to the oral and maxillofacial surgeon in his own clinical practice, and when giving advice to local general dental practitioners.