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We read with interest the recent guidelines for antibiotic prophylaxis produced by the British Society of Gastroenterology which do not support the routine use of antibiotic prophylaxis even for high-risk patients having an endoscopy.1 We would like to present a case which suggests that these guidelines may be underplaying the possible risk in certain patients.
We experienced a 67-year-old patient with recurrent Methicillin resistant Staphylococcus aureus (MRSA) septicaemia due to pacemaker-lead endocarditis, as a complication of a gastroscopy. He had a past medical history of coronary artery bypass grafting and permanent pacemaker implant, and was admitted with a 2-day history of melaena. A day after endoscopy, he developed features of sepsis, complicated by ventricular tachyarrythmia necessitating treatment in the intensive care unit. Blood cultures were positive for MRSA, …
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