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Post-operative Antibiotic Prophylaxis for Dental and Medical Procedures

Now that you have had a total joint replacement, certain precautions must be taken to reduce the chance of infection developing in the bone or around the implant. These precautions should be followed for 2 years after your joint replacement unless your surgeon tells you that you have a risk factor that makes infection more likely for you (such as immune compromise).

ALL patients who have undergone total joint replacement surgery should receive antibiotic prophylaxis* prior to any dental procedures and additional procedures as outlined below for 2 years after your surgery. After 2 years, you should have prophylaxis* if you have an abnormally weak immune system or are having a root canal or dental extraction (these have a greater risk of infection than a routine cleaning).

  1. Patients not allergic to penicillin:

    Cephalexin or amoxicillin 2 grams orally one hour prior to procedure.

  2. Patients not allergic to penicillin and unable to take oral medications:

    Cefazolin 1 gram or ampicillin 2 grams IM/IV one hour prior to the procedure.

  3. Patients allergic to penicillin:

    Clindamycin 600 milligrams orally one hour prior to procedure.

  4. Patients allergic to penicillin and unable to take oral medications:

    Clindamycin 600 milligrams IM/IV one hour prior to the procedure.

Patients who are having a sigmoidoscopy or colonoscopy:

  1. Patients not allergic to penicillin:

    Cephalexin or amoxicillin 2 grams orally one hour prior to procedure.

  2. Patients allergic to penicillin:

    Vancomycin 1 gram intravenously slowly over 1 hour beginning 1 hour before the procedure. PLUS gentamycin 1.5 mg/KG IM or IV 30 minutes before the procedure.

Patients who will have genitourinary manipulation or instrumentation
(cystoscopy or TURP, gastrointestinal or biliary surgery, or any gynecological procedures):

Advise your doctor that you have had a prosthesis implanted and that you need to have antibiotic prophylaxis.

*Antibiotic prophylaxis is a preventative measure taken to avoid infection.

If you suspect any infection, you should be seen promptly and treated by your primary care physician.

Antibiotics are not needed for manicures, pedicures, gynecological exams, eye surgery.