Skip the Antibiotic Prophylaxis Before Colonoscopy in Arthroplasty Patients

A large-database study reinforces a practice guideline that not all of us follow, but we can forgo the antibiotics with confidence

What’s the Claim?

A large-database study found that patients with knee or hip arthroplasties undergoing colonoscopy — with or without biopsy or polypectomy — are not at increased risk of revision for periprosthetic joint infection. With three years of follow-up and vast numbers (over 1.5 million patients), we can feel good about this recommendation. It also made claims about colonoscopy with biopsy somehow being “protective” against revision, which strike me as silly, but the big news here is that a study large enough to answer the question provides a reassuring answer: We shouldn’t give antibiotics to the typical patient who has a hip or knee replacement when (s)he undergoes colonoscopy.

How’s It Stack Up?