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Endoscopy 2004; 36(12): 1123-1125
DOI: 10.1055/s-2004-826118
SFED Guidelines
© Georg Thieme Verlag KG Stuttgart · New York

Antibiotic Prophylaxis for Digestive Endoscopy

M.  Barthet1 , B.  Napoleon1 , G.  Gay1 , T.  Ponchon1 , D.  Sautereau1 , J.  P.  Arpurt1 , C.  Boustiere1 , J.  Boyer1 , J.  M.  Canard1 , P.  A.  Dalbies1 , J.  Escourrou1 , M.  Greff1 , J.  Lapuelle1 , R.  Laugier1 , J.  C.  Letard1 , B.  Marchetti1 , L.  Palazzo1 , B.  Vedrenne1
  • 1Société Française d’Endoscopie Digestive (SFED)
Caution: These guidelines were finalized on August 2003. It is the responsibility of every practitioner to keep up to date with the latest scientific information.
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Publication Date:
01 December 2004 (online)

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Introduction

The aim in antibiotic prophylaxis is to prevent general and local infectious complications related to a medical procedure. General complications are rare in digestive endoscopy (five cases of endocarditis have been reported in the English-language literature [1]), but the rate of local complications can reach 1 % for certain procedures (such as endoscopic retrograde cholangiopancreatography, ERCP).

The benefits of antibiotic prophylaxis should be weighed up against:

Its cost, which is not negligible (depending on the number of endoscopies carried out). The risk of selecting resistant bacteria 2 3 4 5 6 7. The lack of absolute efficacy in preventing endocarditis and local infections, as noted in controlled studies. The high levels of bacteremia also reported in everyday procedures (such as cleaning the teeth). The risk of causing anaphylactic shock or allergic symptoms, the severity of which may be variable.

The use of antibiotic prophylaxis must be justified. These recommendations take into account both the risks associated with the endoscopic procedure and risks inherent to the patients themselves.