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Re: Artificial knee and vaginal exams From: Dr James Lie (splaz@cyllene.uwa.edu.au) Sat Feb 28 00:20:08 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: GEN: Premiers fear collapse of health-care system" Previous message: art fougner, md: "Re: GEN: Premiers fear collapse of health-care system" In reply to: Jane Helwig, MD : "Artificial knee and vaginal exams" http://www.greenhosp.org/pe_pdf/antibiotics.pdf. (page 2 gives the antibiotic recommendation) http://www.clevelandclinicmeded.com/ccjm/april2003/keys.htm (risk of joint infection is low and cost of prophylaxis is higher than none) http://www.ada.org/prof/resources/pubs/jada/reports/report_prophy_statement. pdf The ADA recommendation (2003) can probably be extrapolated to gynae procedures. Probably the most important consideration is a high index of suspicion if the patient (with the joint rplacement) also has other significant co-morbidities. -- James Lie Albany Western Australia -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net]On Behalf Of Jane Helwig, MD Sent: Saturday, 28 February 2004 3:43 AM To: Multiple recipients of list OB-GYN-L 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: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C.: "Re: GEN: Premiers fear collapse of health-care system" Previous message: art fougner, md: "Re: GEN: Premiers fear collapse of health-care system" In reply to: Jane Helwig, MD : "Artificial knee and vaginal exams"

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