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October 17, 1980

Prophylactic Antibiotics and Prosthetic Joints

Author Affiliations

The University of Connecticut Health Center Farmington

JAMA. 1980;244(16):1782. doi:10.1001/jama.1980.03310160010004

To the Editor.—  As new indications for therapeutic and prophylactic antibiotics are proposed, it is essential that they be carefully examined for validity. Lattimer et al (242:2213, 1979) propose that prophylactic antibiotic therapy be administered to prevent hematogenous spread of infection to prosthetic joints when performing procedures that cause a bacteremia.An infected prosthetic joint is associated with great morbidity and expense. Whether hematogenous spread occurs was debated for several years, but it is now clear that it does.1 It is seen in asymptomatic patients whose prosthetic joints have been in place for at least 1 1/2 to two years.I have reviewed the literature since 1975 and have found 87 cases of probable hematogenous prosthetic joint infection. I looked particularly at the source and the identity of the bacteria.When the source of the infection was identified (52 cases), it was always from an established infection elsewhere in