Guidelines

Antibiotic prophylaxis in gastrointestinal endoscopy

M C Allison¹, J A T Sandoe², R Tighe³, I A Simpson⁴, R J Hall⁵, T S J Elliott⁶ prepared on behalf of the Endoscopy Committee of the British Society of Gastroenterology

¹ Gastroenterology Unit, Royal Gwent Hospital, Newport, UK
² Microbiology Unit, Leeds Teaching Hospitals NHS Trust, UK
³ Gastroenterology Unit, Norwich and Norfolk University Hospital, UK
⁴ Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, UK
⁵ Cardiology Department, Norwich and Norfolk University Hospital, UK
⁶ University Hospital Birmingham NHS Foundation Trust, UK

Correspondence to:
Dr M C Allison, Royal Gwent Hospital, Newport NP20 2UB, UK; milesallison@newport11.fsnet.co.uk

Revised version received 19 January 2009

Accepted 27 January 2009

The first 150 words of the full text of this article appear below.

1. INTRODUCTION

Bacteraemia is common following some forms of gastrointestinal endoscopic therapy, such as dilatation or injection sclerotherapy, and can occur with diagnostic endoscopy alone. Fortunately complications resulting from dissemination of endogenous bacteria are uncommon, and infective endocarditis is an extremely rare complication. Furthermore, for most diagnostic and therapeutic procedures there is scant evidence that antibiotic prophylaxis can reduce the incidence of infective complications.

The area that has attracted the most controversy in recent years has been the use of antibiotics to prevent infective endocarditis. The recommendations by the American Heart Association (AHA)¹ have traditionally guided the advice of the national bodies representing endoscopic practice,^{2 3} including the British Society of Gastroenterology (BSG).⁴ The traditional guidance has been that patients at high risk of endocarditis, such as those with a prosthetic (ie, tissue or mechanical) valve and/or a past history of endocarditis should receive antibiotics for all endoscopic procedures. More recently the European . . . [Full text of this article]

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