Current Practices of the 2012 Antibiotic Prophylaxis Recommendations for Orthopaedic Implants in a Mid-West City

Background: This investigation examines practices with the 2012 recommendations by the American Dental Association (ADA) and American Academy of Orthopaedic Surgeons (AAOS) for antibiotic prophylaxis in patients with orthopaedic implants. Quantifying practices allow enforcement efforts to be focused, so the medical community can gain credibility by having united practices on this topic. Methods: A survey regarding the recommendations was mailed to randomly selected clinicians from the ADA and the AAOS membership lists. Participants were sixty orthopaedic surgeons, twenty-five oral surgeons, twenty-four endodontists, twenty-five general dentists, and twenty-one periodontists, all practicing within 100 miles of Omaha, Nebraska. Results: 81.3% of clinicians surveyed were aware of the recommendations, with no significant difference between orthopaedic surgeons and dentists (p=0.074). Of these clinicians, 74.5% indicated that they would recommend prophylactic antibiotics for patients with prosthetic implants prior to invasive dental treatment. Orthopaedic surgeons were significantly more likely to recommend prophylactic antibiotics for these patients (p<0.001). Conclusions: The primary hypothesis that clinicians who are aware of the recommendations would not routinely prescribe prophylactic antibiotics was rejected. The secondary hypothesis that there is no difference in practices between orthopaedic surgeons and dentists was rejected. Further studies should investigate the reason for this difference.