Abstract:
Current international and national prophylactic
antibiotic regimens have been analyzed
in respect of the prevention of bacteremia after
dental and surgical procedures and, therefore,
of joint prosthesis infection. This information
was used to formulate guidelines for the
Department of Maxillofacial and Oral Surgery.
Publications since 2003 were used in this
research. In addition, recommendations of
accredited institutions and associations were
examined. These included the guidelines of
the American Dental Association in association
with the American Academy of
Orthopaedic Surgeons (2003), the American
Heart Association (2007), the Working Party of
the British Society for Antimicrobial
Chemotherapy (2006) and the Australian
Dental Guidelines (2005). No guidelines published
by any institution in South Africa were
found. The general rationale for the use of
antibiotic prophylaxis for surgical (including
dental) interventions is that those procedures
may result in a bacteremia that may cause
infection in joint prostheses. Antibiotics, however,
should therefore be administered to susceptible
patients, e.g. immunocompromised
patients, prior to the development of bacteremia.
The guidelines recommended for use
in South Africa are based solely on those used
outside South Africa. South Africa is regarded
as a developing country with its own population
and demographic characteristics. Eleven
percent of our population is infected with HIV,
and a specific guideline for prophylactic antibiotic
treatment is, therefore, essential.
