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Re: Artificial knee and vaginal exams From: Gail Waldby (gwaldby@willinet.net) Fri Feb 27 14:13:25 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Richard Kaplan: "Re: Decision favors girl hurt at birth" Previous message: DoctorJoe@aol.com: "Re: Artificial knee and vaginal exams" In reply to: Gerald P. Rodríguez: "Re: Artificial knee and vaginal exams" Next in thread: DoctorJoe@aol.com: "Re: Artificial knee and vaginal exams" Jane, this was unreasonable. The Orthopedists don't seem to follow national guidelines for antibiotic use for total joints. At the moment, we don't have to use any bacterial endocarditis prophylactic antibiotics for GI endoscopy unless we are dilating the esophagus; we can do colonoscopic polypectomies without prophylactic antibiotics. The joint replacement patients always want prophylactic antibiotics but I don't think there is any evidence that they help. Gail Waldby, MD Huron SD Gerald P. Rodríguez wrote: >Sounds like muy grande overkill to me--much like when they (orthopaedic >surgeons) first started doing total joint replacements banned female techs >and nurses from wearing scrub *dresses* and made them wear scrub pants. The >"cootie" fall-out theory, as I recall. > >Gerald P. Rodríguez, M.D., FACOG >Santa Fe >~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ >"Never light a match until you know which end of the dog is barking." >--Dave Barry >~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ > >>----- Original Message ----- >From: "Jane Helwig, MD " <jane@helwig.net> >To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@dns.obgyn.net> >Sent: Friday, February 27, 2004 12:40 PM >Subject: Artificial knee and vaginal exams > >>Yesterday a patient came for annual. She had a knee replacement last >>year and was given a card telling her to notify her physician or dentist >>for antibiotic treatment prior to medical procedures including "vaginal >>exams." Accordingly, her primary MD had prescribed an antibiotic which >>the patient took before coming in to me for her pelvic exam and Pap >>smear. >> >>Do we really need to give antibiotic prophylaxis prior to Pap smears for >>patients with artificial joints? >> >>Proceeding quite logically, the patient asked me whether she should take >>antibiotics prior to having intercourse. >> >>Anyone know of infection in artificial joint resulting from vaginal exam >>or Pap smear? >> >>-- >>Jane Helwig, MD, FACOG >>Private practice, 2 MDs, 1 CNM >>Franktown, VA >> > Next message: Richard Kaplan: "Re: Decision favors girl hurt at birth" Previous message: DoctorJoe@aol.com: "Re: Artificial knee and vaginal exams" In reply to: Gerald P. Rodríguez: "Re: Artificial knee and vaginal exams" Next in thread: DoctorJoe@aol.com: "Re: Artificial knee and vaginal exams"

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