Antibiotic Prophylaxis for GI Endoscopy
Publication Date: January 2, 2015
Last Updated: March 14, 2022
RECOMMENDATIONS
We recommend against the routine administration ofantibiotic prophylaxis solely for prevention of IE. (, ⊕⊕⊕o)
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We suggest that patients with high-risk cardiac conditions and established GI tract infections in which enterococci may be part of the infecting bacterial flora should receive antibiotic coverage. (, ⊕⊕oo)
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We recommend against antibiotic prophylaxis before ERCP when obstructive biliary tract disease is not suspected or complete biliary drainage is anticipated. (, ⊕⊕⊕⊕)
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We recommend that antibiotic prophylaxis be administered before ERCP in patients who have had liver transplantation or who have known or suspected biliary obstruction, where there is a possibility of incomplete biliary drainage. Antibiotics that cover biliary flora such as enteric gram-negative organisms and enterococci should be used and continued after the procedure if biliary drainage is incomplete. (, ⊕⊕⊕o)
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We recommend against antibiotic prophylaxis before diagnostic EUS or EUS-FNA of solid lesions of the GI tract. (, ⊕⊕⊕o)
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We suggest antibiotic administration prior to EUS-FNA of mediastinal cysts. (, ⊕⊕oo)
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We suggest administration of prophylactic antibiotics before EUS-FNA of pancreatic or peripancreatic cysts. (, ⊕⊕oo)
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We recommend administration of parenteral cefazolin (or an antibiotic with equivalent microbial coverage) to all patients before PEG/PEJ tube placement. (, ⊕⊕⊕⊕)
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We recommend that all patients with cirrhosis admitted with GI bleeding should have antibiotic therapy instituted at admission with intravenous ceftriaxone (or an antibiotic with equivalent microbial coverage [eg, oral norfloxacin] in patients allergic to or intolerant of ceftriaxone). (, ⊕⊕⊕⊕)
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We recommend against administration of antibiotic prophylaxis before GI endoscopic procedures for patients with synthetic vascular grafts or other nonvalvular cardiovascular devices (eg, implantable electronic devices). (, ⊕⊕⊕⊕)
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We recommend against antibiotic prophylaxis for patients with orthopedic prosthesis undergoing any GI endoscopic procedure. (, ⊕⊕⊕o)
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We suggest administration of antibiotic prophylaxis before endoscopy of the lower GI tract in patients undergoing continuous ambulatory peritoneal dialysis. (, ⊕ooo)
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Recommendation Grading
Overview
Title
Antibiotic Prophylaxis for GI Endoscopy
Authoring Organization
American Society for Gastrointestinal Endoscopy
Publication Month/Year
January 2, 2015
Last Updated Month/Year
January 19, 2024
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adult, Older adult
Health Care Settings
Ambulatory, Hospital, Outpatient
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Prevention, Management
Diseases/Conditions (MeSH)
D016470 - Bacteremia, D016099 - Endoscopy, Gastrointestinal
Keywords
endoscopy, bacteremia, GI endoscopes, Antibiotic prophylaxis
Source Citation
Khashab, M. A., Chithadi, K. V., Acosta, R. D., Bruining, D. H., Chandrasekhara, V., Eloubeidi, M. A., … Cash, B. D. (2015). Antibiotic prophylaxis for GI endoscopy. Gastrointestinal Endoscopy, 81(1), 81–89. doi:10.1016/j.gie.2014.08.008
Methodology
Number of Source Documents
84
Literature Search Start Date
January 1, 1975
Literature Search End Date
December 1, 2013