Antibiotic prophylaxis

1. Antibiotic Prophylaxis in GI
Endoscopy
Hossam GHONEIM, MD
Ass. Professor
Hepatogastroenterology

2. Why Antibiotic Prophylaxis?
• The purpose of antibiotic prophylaxis is to
reduce the risk of iatrogenic infectious
complications

3. Routine daily activity
• Teeth brushing & flossing
– 20-40%
• Chewing foods
– 7 - 51%
• Strong rationale for not administering
antibiotic prophylaxis in routine GI endoscopy

4. High risk procedures
• Endotherapy
– Oesophafeal procedure
• Diltation
• sclerotherapy
– ERCP

5. Low Risk Procedures
• Gastroscopy
– With or without biopsy

6. Special Groups
• Infective Endocarditis risk
– Amoxicillin or Ampicillin
– Vancomycin for patients with hypersensitivity for
Amoxicillin

7. Special Groups
• EUS-FNA
– Not for diagnostic EUS or FNA for solid lesions
– Yes for cystic lesions
• Flouroquinolones prior to procedure and continued for
3 days after

8. Special Groups
• PEG
– Parenteral Cefazolin 30 minutes before procedure

9. Special Groups
• Orthopedic prosthesis
– No antibiotic prophylaxis

10. Special Groups
• Cirrhosis with GI bleeding
– IV Ceftriaxone or oral Norfloxacin

11. Special Groups
• NOTES
– No sufficient data to date. But seems reasonable!

14. Thank You