Table 3.

Cost-effectiveness of antibiotic prophylaxis prior to dental procedures for the prevention of endocarditis and prosthetic joint infection.

Cohort	Antibiotic prophylaxis (AP) strategy	Cost-effectiveness ratio, $ (2017)/QALYa	Source
Endocarditis
Moderate and high-riskb	Oral amoxicillin use prior to invasive dental procedures	-$2814	Franklin 2016 [87]
	Oral clindamycin use prior to invasive dental procedures	-$4989
High-risk	Oral amoxicillin use prior to invasive dental procedures	-$5082
	Oral clindamycin use prior to invasive dental procedures	-$5384
Moderate and high-risk	Oral clarithromycin prior to invasive dental procedures	$119,518	Agha 2005 [58]
	Oral cephalexin prior to invasive dental procedures	$134,954
	Oral clindamycin prior to invasive dental procedures	$137,357
High-risk (prosthetic valve)	Oral clarithromycin prior to invasive dental procedures	$22,840
	Oral cephalexin prior to invasive dental procedures	$19,094
	Oral clindamycin prior to invasive dental procedures	$27,074
Prosthetic Joint Infection
Diabetic TKAcrecipients	Lifetime oral amoxicillin use prior to all dental appointments	$66,000	Present study
TKA recipients	Lifetime oral amoxicillin use prior to dental visits	$256,667	Skaar 2019 [27]
	Oral amoxicillin prior to dental visits for 2 years following arthroplasty	$95,100
THAd recipients	Lifetime oral amoxicillin use prior to dental visits	Dominatede	Skaar 2015 [57]
	Oral amoxicillin prior to dental visits for 2 years following arthroplasty	Dominated
TJAf recipients	Oral penicillin prior to dental visits	Dominated	Tsevat 1989 [71]
	Oral erythromycin prior to dental visits	$35,150

^aRelative to no antibiotic prophylaxis; QALYs: quality-adjusted life-years.

^bUnderlying cardiac complications.

^cTotal knee arthroplasty.

^dTotal hip arthroplasty.

^eDominated strategies reduce quality-adjusted life expectancy (QALE) and increase costs.

^fTotal joint arthroplasty.