antibiotics

[lyn]

What is the reason that they tell you to use antibiotics before dental or any surgery you might have in the future? Does having metal in your body make you more prone to infection? Lyn

[rubyred]

I don't know about that, but I know I was told that if caught any infection I would 100% need to have antibiotics no questions asked.

[hernanu]

We do have a heightened possibility of getting infections localized in the hip joint due to the surgery. This could compromise the device, so it's a good precaution.

It is a small price to pay to make sure the device is in good shape. I have had dental cleanings done, and my dentist knows I had hip surgery - they always make sure I've taken the antibiotics.

[Woodstock Hippy]

My dentist told me that it's because with dental work you can expose the bloodstream to bacteria.  This can cause an infection that could spread to the joint and destroy it.  When he told me that I would have to be pre-medicated, I thought it was going be a big deal.  All I had to do was take one dose four hours before my appointment.

[Pat Walter]

Infections love to attach themselves to metal items like hip replacements.  So it is best to take antiobiotics before any dental work according to many surgeons while others don't require it.

Here is an interesting article about the history of taking antibiotics before dental work and a few medical studies.

http://www.oralhealthgroup.com/news/antibiotic-prophylaxis-and-dental-treatment-in-patients-with-hip-and-knee-arthroplasty/1001430585/

Here is the most recent recommendation I have found

http://www.surfacehippy.info/antiobioticrecommendationaaos.php

and several doctors opinions

http://www.surfacehippy.info/faqdentalantibiotics.php

I personally prefer not to take any chances. I felt that way even before my aortic valve replacement.  Now that I have a bovine tissue valve, I have to take the antibiotics since infection will attack the valve and destroy it.  I have read several stories of people requiring revision open heart surgery to replace a valve destroyed by infection.

So we all have to decide if we should take antibiotics after talking to both our surgeons and our dentists.

Pat

[Tin Soldier]

The articles are very informative, but I've always wondered, and I think a few others here have, why does a prosthetic joint have a predisposition for infection?  The second article mentions that people with plates, screws, and pins do not appear to have the same risk as people with moving joints.  This suggests that it has something to do with the synovial fluid.  I suspect, in the case of the hip, it's probably got the most "hard to reach" syn fluid of any of the prosthetic joints.  It seems like the 100 micrometer spacing of a large femoral head prosthetic would be a good place to harbor bacteria and blood flow (white blood cells,...) probably isn't going there.   Maybe leukocites go into other tissue, don't know.  I think I'm onto something here, but this is just speculation.

Anyone have more info on this?  I'd appreciate getting a better understanding of the mechanism of bacteremia in a prosthetic hip.  I guess, in short,  I'm not going to wait around for my own patrols to make their rounds through the hip and kick out any un-invited guests, so I'll take the antibiotics.

This is also a good reminder to have good dental hygiene, don't forget to floss!

[mslendzion]

What about other types of infections, like sinus or viral colds?  Do these land in the hip too and are in need of antibiotics?

[hernanu]

What about other types of infections, like sinus or viral colds?  Do these land in the hip too and are in need of antibiotics?

Hi, I found this information and put it into an earlier post, but it speaks to your question.

According to this paper from the international journal of medical sciences, these are the bacteria associated with hip joint infections. We're interested in PJI (Prosthetic Joint Infections), NJI is natural joint infections, RA is reactive arthritis:

(source: http://www.medsci.org/v06p0234.htm )



The bacteria identified as causing prosthetic joint infections (PJI) in this study are:

• Staphylococcus aureus - Staph infection, MRSA, etc.
• Coagulase negative staphylococci
• E. Coli
• Pseudomonas aeruginosa - Community acquired pneumonia and ventilator pneumonia

The main thing to look at both a bacterium's ability to infect the area and pathways to get there. It is treatable by antibiotics (since it's a bacteria, common cold is caused by viruses), so identifying it early is probably important. It's always good to check with the doctor. 

The paper does say that prophylactic use of antibiotics was very effective in preventing infection, so our popping antibiotics before dental work, etc. is effective.

[patrick_d]

I was told the same thing from my dentist as Woodstock, basically take 1 pill 4 hours before a cleaning.  Nothing more, seems like no big deal.  My dentist also said that it was REALLY important to keep your mouth very clean and healthy for the rest of your life.  Lots of bad bugs live in your mouth, so it is best to brush, floss, and use antiseptic mouth wash regularly.

[hernanu]

Funny, Patrick - I was told to take 4 pills one hour before a cleaning. Different pills, different doctors, different strokes. 

[Dan L]

Like Hern, I take 4 pills one hour prior to any dental work, cephalxin 500mg, as prescribed by my dentist.

Thanks

[rubyred]

What about other types of infections, like sinus or viral colds?  Do these land in the hip too and are in need of antibiotics?

That's what I was told on my 6 week follow up. To request antibiotics when I catch cold/flu etc.

[SOULEMAN]

Hello am a New Hippy....BH on 11-13-12.........Thanks for all this Info....so am Wondering what Kind of Antibiotics too get before visisting dentist  Thanks everybody...and hey how do i get too the Clothes for sale?..was looking...but maybe too many meds to remember? cant seem too find them

[John C]

Please don't take this as medical facts, but here is my understanding from reading a few studies on the subject. The problem starts when the bacteria gets attached to the metal surfaces. They form a colony, and a film forms over the colony that prevents the bodies immune system, and even to some degree antibiotics, from reaching the bacteria. If it gets to this point, the infection can be very difficult to eradicate. In the very worst cases, the metal parts must be removed, and new prostheses put in after the infection has been eliminated from the surrounding tissues. Even when this is accomplished, there are still risks and the success rates can be down in the 70%s. Luckily long term infection rates are low (at or below 1%), but you can see why there is so much concern. There is currently research on how to break down the bacteria's protective film.
One piece of good news is that there is some argument that these infections are easier to treat in a resurfacing than in a THR.

[Tin Soldier]

That's exactly what I was thinking, John.  I think it's more about the difficulty in treating the infection, than actually getting the infection.  So the notion is, to not get an infection in the first place.

Souleman - ask your surgeon what they recommend for antibiotics.  My surgeon wrote the first script and then just before my next cleaning, my dentist wrote a script for the same anitbiotic and provided a couple years worth.  Dentists are totally familar with this, so you can ask either one, but generally the surgeon is the one that starts the process.

Now I just have to remember to take the meds before my cleaning.  Timely, I have a cleaning tomorrow.   

[imgetinold]

Soulman:  Tin's right.  Either your surgeon OR your dentist knows which are the best to take prior to any dental work.  The dentists do this all the tiime....

[Tin Soldier]

Speaking of, I just took 2000 mg of amoxicillin for breakfast before I had my teeth cleaned.  Yikes, seems like a lot.  Was expecting some stomach issue, but had some leftover pizza and yogurt, yummmy, to give it some ballast and we're all good.

Bring it on bacteria!

[imgetinold]

Mmmmm......nothing like leftover pizza for breakfast........

[Tin Soldier]

Yeah, I'm not sure if the growly guts was from the amoxicilliin or the pizza.