Table 6

Antibiotic prophylaxis recommended for gastrointestinal endoscopy a

Type of gastrointestinal endoscopic procedure and patient conditionGoal of prophylaxisProphylaxis
Percutaneous endoscopic gastrostomyPrevention of peristomal infectionCefazolin 1-g i.v. single dose 30 min before procedure, cefuroxime 1.5-g i.v. single dose, or amoxicillin-clavulanate 1.2-g i.v. single dose
Esophageal sclerotherapy, variceal ligationPrevention of procedure-related bacteremia and peritonitisPiperacillin-tazobactam 4.5-g i.v. single dose (some give 3 times daily), cefotaxime 2-g i.v. single dose, or ceftriaxone 2-g i.v. single dose
    Cirrhosis with acute variceal bleeding
Esophageal dilatation
    Benign/malignant stricture of the esophagus
Endoscopic retrograde cholangiopancreaticography
    Biliary obstruction (e.g., primary sclerosing cholangitis and/or hilar cholangiocarcinoma) when complete biliary drainage is unlikely to be achievedPrevention of cholangitisCiprofloxacin 750-mg single dose orally 1.5–2 h before procedure, piperacillin-tazobactam 4.5-g i.v. single dose 1 h before procedure, or i.v. single dose of gentamicin at 1.5 mg/kg of body weight at time of sedation
    Communicating pancreatic cysts/pseudocystsPrevention of cyst infectionSee above (“Biliary obstruction”)
    Biliary complications after liver transplantationPrevention of cholangitisCiprofloxacin 750-mg single dose orally 1.5–2 h before procedure, gentamicin 1.5-mg/kg i.v. single dose at the time of sedation plus amoxicillin 1-g i.v. single dose, or vancomycin at 20 mg/kg i.v. over at least 1 h
Any gastrointestinal endoscopic procedure
    Patients with cardiovascular risk factorsPrevention of infective endocarditisNot recommended
    Patients with synthetic vascular graft and other cardiovascular devicesPrevention of graft and device infectionNot recommended
    Patients with prosthetic jointsPrevention of septic arthritisNot recommended
  • a Data are based on the guidelines of antibiotic prophylaxis for gastrointestinal endoscopy of the American Society of Gastrointestinal Endoscopy (332) and the Endoscopy Committee of the British Society of Gastroenterology (333). i.v., intravenous.