Jason k. Lowry, MD - Hip, Knee and Shoulder Surgeon
 

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Antibiotics After Your Joint Replacement: A Must Read

If there is one piece of information that I hope you take away from my website it is this:
  The 2009 recommendations from the AAOS about how to prevent an infection in your joint replacement.

There are certain health procedures that you can have done which put your joint replacement at risk for an infection, which is devastating. How does this happen? It comes down to something called "bacteremia", which, simply stated, is when a large influx of bacteria gain access into the blood stream. There are no symptoms of bacteremia. For reasons that we have yet to figure out, these bacteria in the blood stream preferentially travel to your joint replacement & "reek havoc." Symptoms of a joint infection are increased pain, swelling, redness, and even a draining wound. Rarely do people ever experience fevers, chills or malaise. Dental procedures (as simple as a routine teeth cleaning) are the most notorious for causing asymptomatic bacteremia. Most of you out there know this. But, what I've found that a lot of my patients don't realize are the many other diagnostic procedures that can cause bacteremia. A simple way of thinking about this is any procedure that involves a part of your body where food or drink comes into contact with it "from start to finish", if you will, puts your joint replacement at risk. So, upper GI procedures (endoscopy of the esophagus or stomach, ERCP, cholangiogram, etc), lower GI procedures (colonoscopy, sigmoidoscopy), & GU procedures (ie cystoscopy). Below is a table of procedures with the recommended prophylactic antibiotics to be taken. Although the American Dental Association does NOT recommend routine prophylaxis after 2 years after joint replacement, it is my recommendation that lifetime prophylaxis is warranted. The stakes are just way too high, in my opinion.

  Prophylactic antibiotic recommendations for different procedures

My office staff & I, will do our best to ensure you always have refills on your prophylactic antibiotics each time we see you. However, after having a joint replacement, I want you to always be thinking about this for yourself. If we forget, please remind us & we will ensure your pharmacy has enough refills for you at all times.

 

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