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Hot from the press - No AB prophylaxis in the UK
Hot from the press - No AB prophylaxis in the UK
I thought this might interest the clinicians and some of the patients
here.
For those who followed the subject of antibiotic prophylaxis to
prevent endocarditis after dental procedures in the UK, the guidelines
from the British Society for Antimicrobial Chemotherapy issued last
year severely limited the cases where antibiotic prophylaxis for
dental procedures should be used. A cadre of cardiologists presented
some serious objections to the new guidelines and asked the National
Institute for Clinical Excellence to examine the subject and issue
guidance.
It took approximately a year for NICE to complete their report, during
which British dentists were left in a professionally and legally
uneasy situation - do you follow the guidelines of the BSAC or the
cardiology society?
The recommendations by NICE not only upheld BSAC's guidelines, but
went a step further and eliminated the need for AB prophylaxis
entirely. The evidence they used to reach their conclusion was:
There is no consistent association between dental procedures and
infective endocarditis
Toothbrushing causes repetitive bacteraemia that would be more
dangerous than an isolated dental procedure.
Antibiotic prophylaxis has no proven effectiveness against
endocarditis.
Fatal anaphylaxis from antibiotics occurs more frequently than
endocarditis.
I think this will be good for patients, especially the "high risk"
category which under the old guidelines found dental treatment
extremely hard (they had to be treated in hospitals or specialist
centres even for simple procedures).
Regards,
George
I thought this might interest the clinicians and some of the patients
here.
For those who followed the subject of antibiotic prophylaxis to
prevent endocarditis after dental procedures in the UK, the guidelines
from the British Society for Antimicrobial Chemotherapy issued last
year severely limited the cases where antibiotic prophylaxis for
dental procedures should be used. A cadre of cardiologists presented
some serious objections to the new guidelines and asked the National
Institute for Clinical Excellence to examine the subject and issue
guidance.
It took approximately a year for NICE to complete their report, during
which British dentists were left in a professionally and legally
uneasy situation - do you follow the guidelines of the BSAC or the
cardiology society?
The recommendations by NICE not only upheld BSAC's guidelines, but
went a step further and eliminated the need for AB prophylaxis
entirely. The evidence they used to reach their conclusion was:
There is no consistent association between dental procedures and
infective endocarditis
Toothbrushing causes repetitive bacteraemia that would be more
dangerous than an isolated dental procedure.
Antibiotic prophylaxis has no proven effectiveness against
endocarditis.
Fatal anaphylaxis from antibiotics occurs more frequently than
endocarditis.
I think this will be good for patients, especially the "high risk"
category which under the old guidelines found dental treatment
extremely hard (they had to be treated in hospitals or specialist
centres even for simple procedures).
Regards,
George
Re: Hot from the press - No AB prophylaxis in the UK
George wrote:
> I thought this might interest the clinicians and some of the patients
> here.
>
> For those who followed the subject of antibiotic prophylaxis to
> prevent endocarditis after dental procedures in the UK, the guidelines
> from the British Society for Antimicrobial Chemotherapy issued last
> year severely limited the cases where antibiotic prophylaxis for
> dental procedures should be used. A cadre of cardiologists presented
> some serious objections to the new guidelines and asked the National
> Institute for Clinical Excellence to examine the subject and issue
> guidance.
> It took approximately a year for NICE to complete their report, during
> which British dentists were left in a professionally and legally
> uneasy situation - do you follow the guidelines of the BSAC or the
> cardiology society?
> The recommendations by NICE not only upheld BSAC's guidelines, but
> went a step further and eliminated the need for AB prophylaxis
> entirely. The evidence they used to reach their conclusion was:
> There is no consistent association between dental procedures and
> infective endocarditis
> Toothbrushing causes repetitive bacteraemia that would be more
> dangerous than an isolated dental procedure.
> Antibiotic prophylaxis has no proven effectiveness against
> endocarditis.
> Fatal anaphylaxis from antibiotics occurs more frequently than
> endocarditis.
>
> I think this will be good for patients, especially the "high risk"
> category which under the old guidelines found dental treatment
> extremely hard (they had to be treated in hospitals or specialist
> centres even for simple procedures).
>
> Regards,
> George
Thanks. I knew there was an ongoing study. Still, since the
recommendations became known here in the states, I'm finding a lot of
resistance from internists and cardiologists (to say nothing of
orthopedists), and I defer to them of course.
Strange though that over the years there were so many clinical studies
linking individual cases of bacterial endocarditis to proximate dental care.
Steve
George wrote:
> I thought this might interest the clinicians and some of the patients
> here.
>
> For those who followed the subject of antibiotic prophylaxis to
> prevent endocarditis after dental procedures in the UK, the guidelines
> from the British Society for Antimicrobial Chemotherapy issued last
> year severely limited the cases where antibiotic prophylaxis for
> dental procedures should be used. A cadre of cardiologists presented
> some serious objections to the new guidelines and asked the National
> Institute for Clinical Excellence to examine the subject and issue
> guidance.
> It took approximately a year for NICE to complete their report, during
> which British dentists were left in a professionally and legally
> uneasy situation - do you follow the guidelines of the BSAC or the
> cardiology society?
> The recommendations by NICE not only upheld BSAC's guidelines, but
> went a step further and eliminated the need for AB prophylaxis
> entirely. The evidence they used to reach their conclusion was:
> There is no consistent association between dental procedures and
> infective endocarditis
> Toothbrushing causes repetitive bacteraemia that would be more
> dangerous than an isolated dental procedure.
> Antibiotic prophylaxis has no proven effectiveness against
> endocarditis.
> Fatal anaphylaxis from antibiotics occurs more frequently than
> endocarditis.
>
> I think this will be good for patients, especially the "high risk"
> category which under the old guidelines found dental treatment
> extremely hard (they had to be treated in hospitals or specialist
> centres even for simple procedures).
>
> Regards,
> George
Thanks. I knew there was an ongoing study. Still, since the
recommendations became known here in the states, I'm finding a lot of
resistance from internists and cardiologists (to say nothing of
orthopedists), and I defer to them of course.
Strange though that over the years there were so many clinical studies
linking individual cases of bacterial endocarditis to proximate dental care.
Steve
Re: Hot from the press - No AB prophylaxis in the UK
On Mar 19, 12:35 pm, Steven Bornfeld <dentaltwinm...@earthlink,net >
wrote:
> George wrote:
> > I thought this might interest the clinicians and some of the patients
> > here.
>
> > For those who followed the subject of antibiotic prophylaxis to
> > prevent endocarditis after dental procedures in the UK, the guidelines
> > from the British Society for Antimicrobial Chemotherapy issued last
> > year severely limited the cases where antibiotic prophylaxis for
> > dental procedures should be used. A cadre of cardiologists presented
> > some serious objections to the new guidelines and asked the National
> > Institute for Clinical Excellence to examine the subject and issue
> > guidance.
> > It took approximately a year for NICE to complete their report, during
> > which British dentists were left in a professionally and legally
> > uneasy situation - do you follow the guidelines of the BSAC or the
> > cardiology society?
> > The recommendations by NICE not only upheld BSAC's guidelines, but
> > went a step further and eliminated the need for AB prophylaxis
> > entirely. The evidence they used to reach their conclusion was:
> > There is no consistent association between dental procedures and
> > infective endocarditis
> > Toothbrushing causes repetitive bacteraemia that would be more
> > dangerous than an isolated dental procedure.
> > Antibiotic prophylaxis has no proven effectiveness against
> > endocarditis.
> > Fatal anaphylaxis from antibiotics occurs more frequently than
> > endocarditis.
>
> > I think this will be good for patients, especially the "high risk"
> > category which under the old guidelines found dental treatment
> > extremely hard (they had to be treated in hospitals or specialist
> > centres even for simple procedures).
>
> > Regards,
> > George
>
> Thanks. I knew there was an ongoing study. Still, since the
> recommendations became known here in the states, I'm finding a lot of
> resistance from internists and cardiologists (to say nothing of
> orthopedists), and I defer to them of course.
> Strange though that over the years there were so many clinical studies
> linking individual cases of bacterial endocarditis to proximate dental care.
>
> Steve
Dentists were an easy target for blame?
Regards,
George
On Mar 19, 12:35 pm, Steven Bornfeld <dentaltwinm...@earthlink,net >
wrote:
> George wrote:
> > I thought this might interest the clinicians and some of the patients
> > here.
>
> > For those who followed the subject of antibiotic prophylaxis to
> > prevent endocarditis after dental procedures in the UK, the guidelines
> > from the British Society for Antimicrobial Chemotherapy issued last
> > year severely limited the cases where antibiotic prophylaxis for
> > dental procedures should be used. A cadre of cardiologists presented
> > some serious objections to the new guidelines and asked the National
> > Institute for Clinical Excellence to examine the subject and issue
> > guidance.
> > It took approximately a year for NICE to complete their report, during
> > which British dentists were left in a professionally and legally
> > uneasy situation - do you follow the guidelines of the BSAC or the
> > cardiology society?
> > The recommendations by NICE not only upheld BSAC's guidelines, but
> > went a step further and eliminated the need for AB prophylaxis
> > entirely. The evidence they used to reach their conclusion was:
> > There is no consistent association between dental procedures and
> > infective endocarditis
> > Toothbrushing causes repetitive bacteraemia that would be more
> > dangerous than an isolated dental procedure.
> > Antibiotic prophylaxis has no proven effectiveness against
> > endocarditis.
> > Fatal anaphylaxis from antibiotics occurs more frequently than
> > endocarditis.
>
> > I think this will be good for patients, especially the "high risk"
> > category which under the old guidelines found dental treatment
> > extremely hard (they had to be treated in hospitals or specialist
> > centres even for simple procedures).
>
> > Regards,
> > George
>
> Thanks. I knew there was an ongoing study. Still, since the
> recommendations became known here in the states, I'm finding a lot of
> resistance from internists and cardiologists (to say nothing of
> orthopedists), and I defer to them of course.
> Strange though that over the years there were so many clinical studies
> linking individual cases of bacterial endocarditis to proximate dental care.
>
> Steve
Dentists were an easy target for blame?
Regards,
George
Re: Hot from the press - No AB prophylaxis in the UK
Ha ha.
Well, they didn't say IE can't happen after a dental procedure. They
argued that it's been known to happen even after prophylaxis is given
and that the risk of anaphylaxis is greater.
We haven't used ABs for hip replacements for years now.
Regards,
George
Ha ha.
Well, they didn't say IE can't happen after a dental procedure. They
argued that it's been known to happen even after prophylaxis is given
and that the risk of anaphylaxis is greater.
We haven't used ABs for hip replacements for years now.
Regards,
George
Re: Hot from the press - No AB prophylaxis in the UK
George wrote:
> Ha ha.
> Well, they didn't say IE can't happen after a dental procedure. They
> argued that it's been known to happen even after prophylaxis is given
> and that the risk of anaphylaxis is greater.
> We haven't used ABs for hip replacements for years now.
>
> Regards,
> George
Most of the orthopedists ask for antibiotic px at least for the first
two years after a total joint replacement.
Steve
George wrote:
> Ha ha.
> Well, they didn't say IE can't happen after a dental procedure. They
> argued that it's been known to happen even after prophylaxis is given
> and that the risk of anaphylaxis is greater.
> We haven't used ABs for hip replacements for years now.
>
> Regards,
> George
Most of the orthopedists ask for antibiotic px at least for the first
two years after a total joint replacement.
Steve
Re: Hot from the press - No AB prophylaxis in the UK
In article <13u637oi6rqvmd6@corp.supernews,com >,
Steven Bornfeld <dentaltwinmung@earthlink,net > wrote:
> George wrote:
> > Ha ha.
> > Well, they didn't say IE can't happen after a dental procedure. They
> > argued that it's been known to happen even after prophylaxis is given
> > and that the risk of anaphylaxis is greater.
> > We haven't used ABs for hip replacements for years now.
> >
> > Regards,
> > George
>
>
> Most of the orthopedists ask for antibiotic px at least for the first
> two years after a total joint replacement.
>
> Steve
Maybe not all total joint replacements ... or maybe not a number of
years ago. In 1992, when I had two (2) total joint replacements... I
was not put on an extended antibiotic treatment.
W.
In article <13u637oi6rqvmd6@corp.supernews,com >,
Steven Bornfeld <dentaltwinmung@earthlink,net > wrote:
> George wrote:
> > Ha ha.
> > Well, they didn't say IE can't happen after a dental procedure. They
> > argued that it's been known to happen even after prophylaxis is given
> > and that the risk of anaphylaxis is greater.
> > We haven't used ABs for hip replacements for years now.
> >
> > Regards,
> > George
>
>
> Most of the orthopedists ask for antibiotic px at least for the first
> two years after a total joint replacement.
>
> Steve
Maybe not all total joint replacements ... or maybe not a number of
years ago. In 1992, when I had two (2) total joint replacements... I
was not put on an extended antibiotic treatment.
W.
Re: Hot from the press - No AB prophylaxis in the UK
In article
<tmjiatroepidemic-E0ECC4.19444520032008@news.phx.highwinds-media,com >,
The Webby <tmjiatroepidemic@cox,net > wrote:
> In article <13u637oi6rqvmd6@corp.supernews,com >,
> Steven Bornfeld <dentaltwinmung@earthlink,net > wrote:
>
> > George wrote:
> > > Ha ha.
> > > Well, they didn't say IE can't happen after a dental procedure. They
> > > argued that it's been known to happen even after prophylaxis is given
> > > and that the risk of anaphylaxis is greater.
> > > We haven't used ABs for hip replacements for years now.
> > >
> > > Regards,
> > > George
> >
> >
> > Most of the orthopedists ask for antibiotic px at least for the first
> > two years after a total joint replacement.
> >
> > Steve
>
> Maybe not all total joint replacements ... or maybe not a number of
> years ago. In 1992, when I had two (2) total joint replacements... I
> was not put on an extended antibiotic treatment.
>
> W.
P.S. However, I should have mentioned that the "recovery period" was
*two years*.
In article
<tmjiatroepidemic-E0ECC4.19444520032008@news.phx.highwinds-media,com >,
The Webby <tmjiatroepidemic@cox,net > wrote:
> In article <13u637oi6rqvmd6@corp.supernews,com >,
> Steven Bornfeld <dentaltwinmung@earthlink,net > wrote:
>
> > George wrote:
> > > Ha ha.
> > > Well, they didn't say IE can't happen after a dental procedure. They
> > > argued that it's been known to happen even after prophylaxis is given
> > > and that the risk of anaphylaxis is greater.
> > > We haven't used ABs for hip replacements for years now.
> > >
> > > Regards,
> > > George
> >
> >
> > Most of the orthopedists ask for antibiotic px at least for the first
> > two years after a total joint replacement.
> >
> > Steve
>
> Maybe not all total joint replacements ... or maybe not a number of
> years ago. In 1992, when I had two (2) total joint replacements... I
> was not put on an extended antibiotic treatment.
>
> W.
P.S. However, I should have mentioned that the "recovery period" was
*two years*.
Re: Hot from the press - No AB prophylaxis in the UK
In article
<tmjiatroepidemic-4FB776.20221120032008@news.phx.highwinds-media,com >,
The Webby <tmjiatroepidemic@cox,net > wrote:
> In article
> <tmjiatroepidemic-E0ECC4.19444520032008@news.phx.highwinds-media,com >,
> The Webby <tmjiatroepidemic@cox,net > wrote:
>
> > In article <13u637oi6rqvmd6@corp.supernews,com >,
> > Steven Bornfeld <dentaltwinmung@earthlink,net > wrote:
> >
> > > George wrote:
> > > > Ha ha.
> > > > Well, they didn't say IE can't happen after a dental procedure. They
> > > > argued that it's been known to happen even after prophylaxis is given
> > > > and that the risk of anaphylaxis is greater.
> > > > We haven't used ABs for hip replacements for years now.
> > > >
> > > > Regards,
> > > > George
> > >
> > >
> > > Most of the orthopedists ask for antibiotic px at least for the first
> > > two years after a total joint replacement.
> > >
> > > Steve
> >
> > Maybe not all total joint replacements ... or maybe not a number of
> > years ago. In 1992, when I had two (2) total joint replacements... I
> > was not put on an extended antibiotic treatment.
> >
> > W.
>
> P.S. However, I should have mentioned that the "recovery period" was
> *two years*.
P.P.S. Also, as my response applies to the actual subject line: this
surgery was done in the USA not the UK.
Webby
In article
<tmjiatroepidemic-4FB776.20221120032008@news.phx.highwinds-media,com >,
The Webby <tmjiatroepidemic@cox,net > wrote:
> In article
> <tmjiatroepidemic-E0ECC4.19444520032008@news.phx.highwinds-media,com >,
> The Webby <tmjiatroepidemic@cox,net > wrote:
>
> > In article <13u637oi6rqvmd6@corp.supernews,com >,
> > Steven Bornfeld <dentaltwinmung@earthlink,net > wrote:
> >
> > > George wrote:
> > > > Ha ha.
> > > > Well, they didn't say IE can't happen after a dental procedure. They
> > > > argued that it's been known to happen even after prophylaxis is given
> > > > and that the risk of anaphylaxis is greater.
> > > > We haven't used ABs for hip replacements for years now.
> > > >
> > > > Regards,
> > > > George
> > >
> > >
> > > Most of the orthopedists ask for antibiotic px at least for the first
> > > two years after a total joint replacement.
> > >
> > > Steve
> >
> > Maybe not all total joint replacements ... or maybe not a number of
> > years ago. In 1992, when I had two (2) total joint replacements... I
> > was not put on an extended antibiotic treatment.
> >
> > W.
>
> P.S. However, I should have mentioned that the "recovery period" was
> *two years*.
P.P.S. Also, as my response applies to the actual subject line: this
surgery was done in the USA not the UK.
Webby
Re: Hot from the press - No AB prophylaxis in the UK
I still occasionally get a cardiologist or orthopedist who wants to pre-med
patients for dental work. I ask for verification, and if they repeat the
same line, I will INSIST that they write the Rx, NOT me. **** I refuse
to write the Rx. **** They like to FAX me the drugs and strength they
want. I send it back to them saying they MUST write the Rx. If the patient
gets anaphylaxis, it is their responsibility. At this point most of them
re-read the recommendations and write back that the patient does NOT need
pre-med. Go figure !
"Steven Bornfeld" <dentaltwinmung@earthlink,net > wrote in message
news:13u637oi6rqvmd6@corp.supernews,com ...
> George wrote:
>> Ha ha.
>> Well, they didn't say IE can't happen after a dental procedure. They
>> argued that it's been known to happen even after prophylaxis is given
>> and that the risk of anaphylaxis is greater.
>> We haven't used ABs for hip replacements for years now.
>>
>> Regards,
>> George
>
>
> Most of the orthopedists ask for antibiotic px at least for the first two
> years after a total joint replacement.
>
> Steve
I still occasionally get a cardiologist or orthopedist who wants to pre-med
patients for dental work. I ask for verification, and if they repeat the
same line, I will INSIST that they write the Rx, NOT me. **** I refuse
to write the Rx. **** They like to FAX me the drugs and strength they
want. I send it back to them saying they MUST write the Rx. If the patient
gets anaphylaxis, it is their responsibility. At this point most of them
re-read the recommendations and write back that the patient does NOT need
pre-med. Go figure !
"Steven Bornfeld" <dentaltwinmung@earthlink,net > wrote in message
news:13u637oi6rqvmd6@corp.supernews,com ...
> George wrote:
>> Ha ha.
>> Well, they didn't say IE can't happen after a dental procedure. They
>> argued that it's been known to happen even after prophylaxis is given
>> and that the risk of anaphylaxis is greater.
>> We haven't used ABs for hip replacements for years now.
>>
>> Regards,
>> George
>
>
> Most of the orthopedists ask for antibiotic px at least for the first two
> years after a total joint replacement.
>
> Steve
Re: Hot from the press - No AB prophylaxis in the UK
When I had dental care (in the hospital) just short of one year after
two total joint replacements (December 1992) ... even back then, there
was no recommendation of pre-medicating with antibiotics. The reason I
think this is because medical doctors just don't ordinarily "get it"
when they hear that the patient has "artificial jaw joints". They just
hear "TMJ" .... or they don't think that replacing jaw joints are really
replacing joints... ugh. So I like to think that it worked for me
rather than against me if the treatment is essentially over-kill (pun
intended).
And again in 2000, hospitalized dental care ... still sporting the two
total joints and there wasn't so much as a question (and it was several
years behind the two-year recovery period which would have ended in Jan
1994.)
If I had two artificial hips or knees, I can't help but wonder if there
wouldn't have been more of an issue between the medical doctor and the
dental team.
Webby
In article <z4ydnfqWdpdCiHnanZ2dnUVZ_vWtnZ2d@wideopenwest,com >,
"Amatus Cremona" <arcus@martole.e.,com > wrote:
> I still occasionally get a cardiologist or orthopedist who wants to pre-med
> patients for dental work. I ask for verification, and if they repeat the
> same line, I will INSIST that they write the Rx, NOT me. **** I refuse
> to write the Rx. **** They like to FAX me the drugs and strength they
> want. I send it back to them saying they MUST write the Rx. If the patient
> gets anaphylaxis, it is their responsibility. At this point most of them
> re-read the recommendations and write back that the patient does NOT need
> pre-med. Go figure !
>
>
> "Steven Bornfeld" <dentaltwinmung@earthlink,net > wrote in message
> news:13u637oi6rqvmd6@corp.supernews,com ...
> > George wrote:
> >> Ha ha.
> >> Well, they didn't say IE can't happen after a dental procedure. They
> >> argued that it's been known to happen even after prophylaxis is given
> >> and that the risk of anaphylaxis is greater.
> >> We haven't used ABs for hip replacements for years now.
> >>
> >> Regards,
> >> George
> >
> >
> > Most of the orthopedists ask for antibiotic px at least for the first two
> > years after a total joint replacement.
> >
> > Steve
When I had dental care (in the hospital) just short of one year after
two total joint replacements (December 1992) ... even back then, there
was no recommendation of pre-medicating with antibiotics. The reason I
think this is because medical doctors just don't ordinarily "get it"
when they hear that the patient has "artificial jaw joints". They just
hear "TMJ" .... or they don't think that replacing jaw joints are really
replacing joints... ugh. So I like to think that it worked for me
rather than against me if the treatment is essentially over-kill (pun
intended).
And again in 2000, hospitalized dental care ... still sporting the two
total joints and there wasn't so much as a question (and it was several
years behind the two-year recovery period which would have ended in Jan
1994.)
If I had two artificial hips or knees, I can't help but wonder if there
wouldn't have been more of an issue between the medical doctor and the
dental team.
Webby
In article <z4ydnfqWdpdCiHnanZ2dnUVZ_vWtnZ2d@wideopenwest,com >,
"Amatus Cremona" <arcus@martole.e.,com > wrote:
> I still occasionally get a cardiologist or orthopedist who wants to pre-med
> patients for dental work. I ask for verification, and if they repeat the
> same line, I will INSIST that they write the Rx, NOT me. **** I refuse
> to write the Rx. **** They like to FAX me the drugs and strength they
> want. I send it back to them saying they MUST write the Rx. If the patient
> gets anaphylaxis, it is their responsibility. At this point most of them
> re-read the recommendations and write back that the patient does NOT need
> pre-med. Go figure !
>
>
> "Steven Bornfeld" <dentaltwinmung@earthlink,net > wrote in message
> news:13u637oi6rqvmd6@corp.supernews,com ...
> > George wrote:
> >> Ha ha.
> >> Well, they didn't say IE can't happen after a dental procedure. They
> >> argued that it's been known to happen even after prophylaxis is given
> >> and that the risk of anaphylaxis is greater.
> >> We haven't used ABs for hip replacements for years now.
> >>
> >> Regards,
> >> George
> >
> >
> > Most of the orthopedists ask for antibiotic px at least for the first two
> > years after a total joint replacement.
> >
> > Steve
Re: Hot from the press - No AB prophylaxis in the UK
agreed
"The Webby" <tmjiatroepidemic@cox,net > wrote in message
news:tmjiatroepidemic-F2351E.13260421032008@news.phx.highwinds-media,com ...
> When I had dental care (in the hospital) just short of one year after
> two total joint replacements (December 1992) ... even back then, there
> was no recommendation of pre-medicating with antibiotics. The reason I
> think this is because medical doctors just don't ordinarily "get it"
> when they hear that the patient has "artificial jaw joints". They just
> hear "TMJ" .... or they don't think that replacing jaw joints are really
> replacing joints... ugh. So I like to think that it worked for me
> rather than against me if the treatment is essentially over-kill (pun
> intended).
>
> And again in 2000, hospitalized dental care ... still sporting the two
> total joints and there wasn't so much as a question (and it was several
> years behind the two-year recovery period which would have ended in Jan
> 1994.)
>
> If I had two artificial hips or knees, I can't help but wonder if there
> wouldn't have been more of an issue between the medical doctor and the
> dental team.
>
> Webby
>
> In article <z4ydnfqWdpdCiHnanZ2dnUVZ vWtnZ2d@wideopenwest,com >,
> "Amatus Cremona" <arcus@martole.e.,com > wrote:
>
>> I still occasionally get a cardiologist or orthopedist who wants to
>> pre-med
>> patients for dental work. I ask for verification, and if they repeat the
>> same line, I will INSIST that they write the Rx, NOT me. **** I
>> refuse
>> to write the Rx. **** They like to FAX me the drugs and strength they
>> want. I send it back to them saying they MUST write the Rx. If the
>> patient
>> gets anaphylaxis, it is their responsibility. At this point most of them
>> re-read the recommendations and write back that the patient does NOT need
>> pre-med. Go figure !
>>
>>
>> "Steven Bornfeld" <dentaltwinmung@earthlink,net > wrote in message
>> news:13u637oi6rqvmd6@corp.supernews,com ...
>> > George wrote:
>> >> Ha ha.
>> >> Well, they didn't say IE can't happen after a dental procedure. They
>> >> argued that it's been known to happen even after prophylaxis is given
>> >> and that the risk of anaphylaxis is greater.
>> >> We haven't used ABs for hip replacements for years now.
>> >>
>> >> Regards,
>> >> George
>> >
>> >
>> > Most of the orthopedists ask for antibiotic px at least for the first
>> > two
>> > years after a total joint replacement.
>> >
>> > Steve
agreed
"The Webby" <tmjiatroepidemic@cox,net > wrote in message
news:tmjiatroepidemic-F2351E.13260421032008@news.phx.highwinds-media,com ...
> When I had dental care (in the hospital) just short of one year after
> two total joint replacements (December 1992) ... even back then, there
> was no recommendation of pre-medicating with antibiotics. The reason I
> think this is because medical doctors just don't ordinarily "get it"
> when they hear that the patient has "artificial jaw joints". They just
> hear "TMJ" .... or they don't think that replacing jaw joints are really
> replacing joints... ugh. So I like to think that it worked for me
> rather than against me if the treatment is essentially over-kill (pun
> intended).
>
> And again in 2000, hospitalized dental care ... still sporting the two
> total joints and there wasn't so much as a question (and it was several
> years behind the two-year recovery period which would have ended in Jan
> 1994.)
>
> If I had two artificial hips or knees, I can't help but wonder if there
> wouldn't have been more of an issue between the medical doctor and the
> dental team.
>
> Webby
>
> In article <z4ydnfqWdpdCiHnanZ2dnUVZ vWtnZ2d@wideopenwest,com >,
> "Amatus Cremona" <arcus@martole.e.,com > wrote:
>
>> I still occasionally get a cardiologist or orthopedist who wants to
>> pre-med
>> patients for dental work. I ask for verification, and if they repeat the
>> same line, I will INSIST that they write the Rx, NOT me. **** I
>> refuse
>> to write the Rx. **** They like to FAX me the drugs and strength they
>> want. I send it back to them saying they MUST write the Rx. If the
>> patient
>> gets anaphylaxis, it is their responsibility. At this point most of them
>> re-read the recommendations and write back that the patient does NOT need
>> pre-med. Go figure !
>>
>>
>> "Steven Bornfeld" <dentaltwinmung@earthlink,net > wrote in message
>> news:13u637oi6rqvmd6@corp.supernews,com ...
>> > George wrote:
>> >> Ha ha.
>> >> Well, they didn't say IE can't happen after a dental procedure. They
>> >> argued that it's been known to happen even after prophylaxis is given
>> >> and that the risk of anaphylaxis is greater.
>> >> We haven't used ABs for hip replacements for years now.
>> >>
>> >> Regards,
>> >> George
>> >
>> >
>> > Most of the orthopedists ask for antibiotic px at least for the first
>> > two
>> > years after a total joint replacement.
>> >
>> > Steve
