Risks of Infection from Gastrointestinal Endoscopy

The occurrence of bacteremia during gastrointestinal (GI) endoscopic procedures has been reported in numerous studies, although it is usually transient and clinically significant infectious complications are uncommon. Although reports of infectious endocarditis (IE) associated with endoscopy are extremely rare, antibiotic prophylaxis has historically been recommended for susceptible patients undergoing procedures with a high risk of bacteremia. Recent guidelines from the American Heart Association no longer recommend the use of prophylactic antibiotics for prevention of IE during GI endoscopy. This article will review the risk of bacteremia associated with various gastrointestinal endoscopic procedures, and discuss the rationale for antibiotic prophylaxis recommendations.