Antibiotic Prophylaxis Instructions

Your total joint replacement is at a low risk of becoming infected by bacteria traveling through your bloodstream. This risk can be lowered by promptly treating any infection in your body, particularly those in your gums and teeth, skin, ears, kidneys and bladder, intestines, lungs, and heart.

The most critical period is the first two years after joint placement. If you develop sudden pain in your prosthetic joint during the course of a bacterial infection you should seek medical attention promptly.

During the first two postoperative years, you should receive antibiotic prophylaxis before dental procedures that involve substantial bleeding like dental extractions, root canal, dental implant placement, teeth cleaning, among others. You may also need antibiotics before some urological procedures, or during the course of other conditions such as recent or recurrent urinary tract infection, or recent / recurrent prostatitis.

Suggested antibiotic prophylaxis regimen for dental procedures

  • Patients not allergic to penicillin: cephalexin, cephradine or amoxicillin: 2 grams orally 1 hour prior to dental procedure.
  • Patients not allergic to penicillin and unable to take oral medications: cefazolin 1 gram or ampicillin 2 grams intramuscularly or intravenously 1 hour prior to the procedure.
  • Patients allergic to penicillin: clindamycin: 600 mg orally 1 hour prior to the dental procedure.
  • Patients allergic to penicillin and unable to take oral medications: clindamycin 600 mg intravenously, 1 hour prior to the procedure.

Suggested antibiotic prophylaxis regimen for urological procedures

  • A single systemic level dose of a quinolone (e.g., ciprofloxacin, 500 mg; levofloxacin, 500 mg; ofloxacin, 400 mg) orally one to two hours preoperatively.
  • Ampicillin 2 gm IV (or vancomycin 1 gm IV over 1 to 2 hours, in patients allergic to ampicillin) plus gentamicin 1.5 mg/kg IV 30 to 60 minutes preoperatively.

You don’t need antibiotic prophylaxis before receiving a manicure, pedicure, gynecologic routine examination, injection, or eye surgery.

Long term care: You should have periodic examinations and X-rays of your joint replacement. I will discuss with you the frequency of such visits based on your age and activity level. Follow us on Facebook, Twitter and Instagram (@NYHipKnee) for periodic updates on conditions that may affect your joint replacement, updates on how to stay healthy and make your implant last longer.