By the way, doctor: I have a joint replacement - should I take antibiotics before procedures?
That said, not all immune systems are healthy enough to mop up bacteria in the bloodstream, and some procedures are more likely than others to release bacteria into the bloodstream. The AAOS, ADA, and AUA say it's fine to consider antibiotics to prevent infection of a prosthetic joint in a patient who is very susceptible to infection or who is having a procedure that carries an especially high risk of bacteremia. People are at higher risk for infection in the first two years after joint replacement or if they've had a prior prosthetic joint infection. The risk is also higher in those who are immune-compromised or malnourished or have inflammatory arthritis, type 1 diabetes, or hemophilia. Higher-risk medical procedures include kidney stone removal, urinary tract incisions, and endoscopy of the kidney or ureter. Dental procedures most likely to cause trouble are tooth extractions, periodontal procedures, dental implants, and root canals.
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