The prevention of infection after a total joint replacement

Prevention of Infection Following a Total Joint Replacement
You have undergone a total joint replacement procedure. There are instances where
infection in one part of your body may cause bacteria to circulate in your blood, possibly
resulting in infection at the site of your implant. Therefore, it is essential that you seek
prompt treatment of infections anywhere in your body. The signs of an infection in your
total joint implant might include pain, swelling, fever, warmth over the joint, or other
unusual symptoms. You should contact our office if you have any concerns that
you might have an infection in your total joint implant. You should contact your
physician or your dentist if you have any concerns that you might have an infection in
other areas of your body.
Dental Care
Good dental hygiene is important and you should see your dentist for regular dental
care whether or not you are having a dental problem. Before you have any dental
procedure we recommend that you take 2 grams of cephalexin (Keflex) one hour prior
to the procedure. If you are allergic to cephalexin or penicillin or are unable to take
cephalexin (Keflex) for any other reason we recommend that you take clindamycin 600
mg one hour before the procedure. Your dentist can order that for you, or you can
contact our office at 360-254-6161 for a prescription prior to your dental appointment.
These guidelines should be followed for the rest of your lifetime.
Other Invasive Procedures
When having any type of surgery or invasive procedure, it is important to inform your
doctor who will be performing the procedure that you have had a total joint replacement.
Your doctor can then make the determination of whether or not prophylactic antibiotics
are needed. Please share the prescribing guidelines on page 2 with your doctor.
Please contact our office at 360-254-6161 if you need additional copies of these
recommendations. These guidelines should be followed for the rest of your lifetime.
(See attached sheet for prescribing details.)
The above recommendations follow the February 2009 guidelines of the American Academy of Orthopaedic
Surgeons which can be viewed at: http://www.aaos.org/about/papers/advistmt/1033.asp
Preventative Antibiotic Recommendations for Procedures
Procedure Antibiotic
Dose Timing
Orthopedic
Vascular

Gastrointestinal
Esophageal,

Head and neck Clindamycin +

Obstetric and Cefoxitin, cefazolin
gynecological Ampicillin/sulbactam

Genitourinary Ciprofloxacin
500 mg po or 1 hour prior to procedure 400 mg IV Begin dose 60 minutes prior to procedure Ophthalmic
ofloxacin, or subconjunctivally subconjunctivally The above recommendations follow the February 2009 guidelines of the American Academy of Orthopaedic Surgeons which can be viewed at:

Source: http://www.reboundmd.com/assets/prophylactic-antibiotics-final-draft.pdf