TY - JOUR
T1 - Antibiotic prophylaxis for dental patients with joint prostheses?
AU - Jacobson, Jed J.
AU - Schweitzer, Stuart
AU - DePorter, David J.
AU - Lee, J. Jack
N1 - Funding Information:
42. Oral Health of U.S. Adults. U.S. Dept. of Health and Human Services, Public Health Ser-vice, National Institutes of Health Publication No. 87-2868, Aug. 1987.
PY - 1990/10
Y1 - 1990/10
N2 - A decision analysis was performed to assess the risks, costs, and effects of no prophylaxis, oral penicillin, and cephalexin regimens currently being debated for dental patients at risk for late prosthetic joint infection (LPJI). The analysis suggests that there is a very small risk of LPJI (29,3 cases per 106 dental visits), which is outweighed by a greater risk of death with an oral penicillin strategy than with a “no prophylaxis” strategy (2.31:1.93). An oral cephalosporin appears to spare life and limb but does so at an extremely high cost. Over 500,000 must be spent to spare one year of life, while 480,000 needs to be spent to prevent one case of LPJI. Some individual dental patients may still be at a much greater risk for LPJI than others. However, from the evidence to date, routine predental antibiotic prophylaxis for all prosthetic joint patients is a very expensive preventive strategy and is not cost-effective. However, clinical experience suggests that antibiotic prophylaxis may be appropriate in some situations.
AB - A decision analysis was performed to assess the risks, costs, and effects of no prophylaxis, oral penicillin, and cephalexin regimens currently being debated for dental patients at risk for late prosthetic joint infection (LPJI). The analysis suggests that there is a very small risk of LPJI (29,3 cases per 106 dental visits), which is outweighed by a greater risk of death with an oral penicillin strategy than with a “no prophylaxis” strategy (2.31:1.93). An oral cephalosporin appears to spare life and limb but does so at an extremely high cost. Over 500,000 must be spent to spare one year of life, while 480,000 needs to be spent to prevent one case of LPJI. Some individual dental patients may still be at a much greater risk for LPJI than others. However, from the evidence to date, routine predental antibiotic prophylaxis for all prosthetic joint patients is a very expensive preventive strategy and is not cost-effective. However, clinical experience suggests that antibiotic prophylaxis may be appropriate in some situations.
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U2 - 10.1017/S0266462300004220
DO - 10.1017/S0266462300004220
M3 - Article
C2 - 2150670
AN - SCOPUS:0025643057
SN - 0266-4623
VL - 6
SP - 569
EP - 587
JO - International Journal of Technology Assessment in Health Care
JF - International Journal of Technology Assessment in Health Care
IS - 4
ER -