Table 6.

Antibiotic prophylaxis recommended for gastrointestinal endoscopy^a

Type of gastrointestinal endoscopic procedure and patient condition	Goal of prophylaxis	Prophylaxis
Percutaneous endoscopic gastrostomy	Prevention of peristomal infection	Cefazolin 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 ligation	Prevention of procedure-related bacteremia and peritonitis	Piperacillin-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 achieved	Prevention of cholangitis	Ciprofloxacin 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/pseudocysts	Prevention of cyst infection	See above (“Biliary obstruction”)
Biliary complications after liver transplantation	Prevention of cholangitis	Ciprofloxacin 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 factors	Prevention of infective endocarditis	Not recommended
Patients with synthetic vascular graft and other cardiovascular devices	Prevention of graft and device infection	Not recommended
Patients with prosthetic joints	Prevention of septic arthritis	Not recommended

^aData 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.