Antibiotics for prevention of periprosthetic joint infection following dentistry: time to focus on data.

The population of individuals with artificial joints is steadily increasing, because more devices are implanted, and the life span of people with implants is longer. During a 10-year period, the total number of knee replacements increased from 270,000 to 550,000 per year, and the total number of total hip replacements increased from 120,000 to 200,000 per year in the United States [1]. Prosthetic joint– associated infection (PJI) is a devastating complication that occurs in 0.3%–1% of those patients who undergo total hip arthroplasty and in 1%–2% of patients after total knee arthroplasty [2]. Of these episodes, 35%–40% occur by the hematogenous route [3]. Most of these episodes are sequelae of Staphylococcus aureus sepsis, skin infection, or urosepsis [4–6]. It is conceivable that a small portion of these PJI episodes are caused by transitional bacteremia during dental work. However, clinical experience does not favour this hypothesis, and to date, only few indirect data were available for discussion.