Monday, April 25, 2011

Shoulder arthritis: antibiotics after joint replacement

A common question after a shoulder joint replacement surgery regards taking antibiotics for future procedures. Obviously the goal is to minimize the risk of bacteria in the bloodstream that may result in an infection of the joint replacement.

Our usual recommendations are that (1) any elective dental (cleaning, root canals, gum surgery, etc) or other surgical procedure should be done at least six weeks before the joint replacement and the wounds should have healed completely, (2) no elective surgery be done within three months after the joint replacement and (3) prophylactic antibiotics be used for life after a shoulder joint replacement for arthritis. Of course, individual treatment plans need to be developed for individuals - these are only general guidelines based on the 2009 recommendations of the American Academy of Orthopaedic Surgeons. I recommend that you take a moment to read their information statement on antibiotics.

Often our recommendations are:
Dental work: 2 grams of cephalexin 1 hour prior to the procedure for individuals without penicillin allergy, 600mg of clindamycin 1 hour prior to the dental procedure for individuals with penicillin allergy.

The AAOS recommendations for other procedures are shown below.

Again, these are only general guidelines. The specifics for an individual patient must be established by the treating physician/surgeon.


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