ANTIBIOTIC PROPHYLAXIS NOT INDICATED FOR DENTAL PROCEDURES IN PATIENTS WITH JOINT PROSTHESES: A NEW DUTCH GUIDELINE

AimA previous Dutch guideline for prophylaxis of hematogenous PJI (HPJI) caused defensive medicine and incorrect own guidelines. There was a need for a better national guideline, developed cooperatively by orthopedic surgeons and dentist.MethodA committee of Dutch Orthopedic and Dental Society, performed a systematic literature review to answer the question: “Is there a difference in the risk for hematogenous infection between always or never giving antibiotic prophylaxis to patients with a joint prosthesis undergoing a dental procedure”.We included 9 papers as follows:1.RCT's and systematic reviews: 539 abstracts > 33 full papers > 1 paper included.2.observational studies: 289 abstracts > 12 full papers > 5 papers.3.reference-to-reference: 3 papers.The nine papers’ quality was scored according the GRADE method.In addition we studied in non-included literature on further information about additional questions of pathophysiology, risk factors and risk procedures.ResultsNo evidence was found that prophylact...