Dear Patient:

Please keep the following HIP AND BONE REPLACEMENT ANTIBIOTIC PROTECTION information for future reference.

Thank you.

HIP AND KNEE REPLACEMENT ANTIBIOTIC PROTECTION

All patients after joint replacement surgery need to be aware of the need for antibiotic protection for certain dental and medical procedures to reduce the risk of infection. Recently, the indication for antibiotic protection has been reviewed and updated by the American Dental Association (ADA) and the American Academy of Orthopaedic Surgeons (AAOS). All joint replacement patients should be aware of the following indications and procedures requiring antibiotic protection, and should retain this letter for future reference. Patients should also inform their dentists, primary care physicians, and other medical personnel of their joint replacement before any procedure.

ANTIBIOTIC PROTECTION IS NEEDED FOR THE FIRST TWO (2) YEARS FOLLOWING JOINT REPLACEMENT FOR ALL PATIENTS

THE FOLLOWING PATIENTS NEED ANTIBIOTIC PROTECTION FOR THE REST OF THEIR LIVES FOLLOWING JOINT REPLACEMENT…

*Immunocompromised/immunosuppressed patients, for example, patients with rheumatoid arthrititis, systemic lupus erythematosus, organ transplant, chemotherapy/radiation therapy

*Insulin-dependent (TYPE 1) diabetes

*Previous prosthetic joint infections

*Malnourishment

*Hemophilia

ANTIBIOTIC DOSAGE: AMOXICILLIN, CEPHALEXIN, CEPHADRINE

2 GRAMS ORALLY 1 HOUR PRIOR TO PRODEDURE

If allergic to penicillin: CLINDAMYCIN

600 mg ORALLY 1 HOUR PRIOR TO PROCEDURE

PROCEDURES REQUIRING ANTIBIOTIC PROTECTION:

· Prophylactic cleaning of teeth or implants where bleeding is anticipated, dental extractions, periodontal procedures, dental implant, root canal, initial placement of orthodontic bands, intraligamentary local anesthetic injections

· Tonsillectomy and/or adenoidectomy

· Surgical operations involving intestinal or respiratory mucosa

· Bronchoscopy with rigid bronchoscope

· Sclerotherapy for esophageal varices

· Esophageal dilation

· Gallbladder surgery

· Cytoscopy

· Urethral dilation

· Urethral catheterization if urinary tract infection is present

· Prostatic surgery

· Incision and drainage of infected tissue

· Vaginal hysterectomy

· Vaginal delivery in the presence of infection

PROCEDURES NOT REQUIRING ANTIBIOTIC PROTECTION:

· Dental procedures not likely to induce bleeding, such as simple adjustment of an orthodontic appliance or fillings about the gum line

· Injection of local intra-oral anesthetic

· Shedding of primary teeth

· Tympanostomy tube insertion

· Endotracheal intubation

· Bronchoscopy with flexible bronchoscope

· Cardiac catheterization

· Endoscopy with or without gastrointestinal bypass

· Caesarean section

· In the absence of infection for urethral cauterization, dilation and curettage, and uncomplicated vaginal deliveries

· Lens implants

THIS LISTING IS INTENDED TO SERVE AS A GUIDE ONLY, NOT A COMPLETE LISTING OF ALL PROCEDURES. CLINICAL JUDGMENT BY YOUR PHYSCIAN MAY BE MADE IN SOME SELECTED CIRCUMSTANCES. ANYTIME YOU ARE IN DOUBT, PLEASE CONSULT YOUR PHYSICIAN.

Please retain this article for future reference.