Do you still need to pre-medicate from that knee surgery?
In its recent report, “Antimicrobial Resistance: Global Report on Surveillance,” the World Health Organization (WHO) cautions about the overwhelming consequences of antibiotics losing their effectiveness to fight disease, as the risk of diseases that have been controlled could surface again.
Apparently, there is an ongoing debate about the use of antibiotics post surgery that is unsettled. The professionals are still trying to work out the recommendations to the patient. While there may be a link between periodontal disease, bacteria freed from cleanings, the risk of infection appears suspect after a year or two. We are no longer recommending or requiring that you pre-medicate before treatment and are deferring to your physician for that judgment call.
There are times when dentists recommend a patient take antibiotics before certain dental procedures.
Essentially, you have bacteria in our mouths that certain procedures might allow or facilitate the entry of bacterium into the bloodstream. For most of us, this isn’t an issue. A healthy immune system prevents these bacteria from causing any harm. Yet, for some people bacteremia can cause an infection elsewhere in the body.
Antibiotics are recommended to be taken in advance of treatment for a small number of people who have specific heart conditions.
According to the American Heart Association guidelines, antibiotic prophylaxis should be considered for people with:
Artificial heart valves.
A history of an infection of the lining of the heart or heart valves known as infective endocarditis.
A heart transplant in which a problem develops with one of the valves inside the heart.
Heart conditions that are present from birth, such as:
Unrepaired cyanotic congenital heart disease, including people with palliative shunts and conduit.
Defects repaired with a prosthetic material or device—whether placed by surgery or catheter intervention—during the first six months after repair.
Cases in which a heart defect has been repaired, but a residual defect remains at the site or adjacent to the site of the prosthetic patch or prosthetic device used for the repair.
Antibiotic guidelines have also been developed for people who have orthopedic implants. In 2012, the ADA and American Association of Orthopedic Surgeons updated the recommendations and no longer recommend antibiotics for everyone with artificial joints. As such, your provider may rely more on your personal medical history to determine whether or not antibiotics are appropriate for people with orthopedic implants.
In addition, antibiotic premedication might be appropriate for patients who have compromised immune systems due to diabetes, rheumatoid arthritis, cancer, chemotherapy, and chronic steroid use, all of which increase the risk of infection. If you have a heart condition, a compromised immune system or an orthopedic implant, talk with your dentist or physician about whether antibiotic pre-treatment is right for you. If we can be of assistance, feel free to contact us.