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.