The correct answer is A. Advise him that he does not need any antibiotics.

Antibiotics are not indicated for the majority of healthy patients with total joint prosthesis, unless the surgical site is infected, an oral site, or sites at high risk for future surgical site infection. Given this low risk location without breach of mucosa and lack of current infection, antibiotics would not be indicated.

Patients who require antibiotic prophylaxis prior to surgery, due to a breach of the oral mucosa or an infected surgical site, may have any of the regimens above. Cephalexin 2 gm PO x 1 pre procedure is widely used, with any of the other regimens being appropriate in PCN-allergic patients.

 

References:

Bae-Harboe YS, Liang CA. Perioperative antibiotic use of dermatologic surgeons in 2012. Dermatol Surg. 2013;39:1592-1601.