Adult
GIT & Biliary Surgery - Endoscopic procedures
Link to General Principles, including redosing table
Endoscopic procedures (gastroenterology)
Antibiotic Prophylaxis is NOT indicated for the majority of patients undergoing endoscopic procedures, including patients with valvular heart disease or prosthetic joints.
Antibiotic prophylaxis is recommended for
- patients with severe neutropenia OR haematologic malignancies
- patients with cirrhosis AND ascites undergoing procedures such as oesophageal dilation or endoscopic sclerotherapy
- all patients prior to placement of a PEG or PEJ tube.
Preferred (including for penicillin allergy (non-severe)): cefazolin iv (see dosing table below)
| cefazolin iv dose | |
| Weight under 50kg | 1g |
| Weight 50kg to less than 120kg | 2g |
| Weight 120kg or more | 3g |
| Creatinine Clearance less than 10ml/min or patient receiving haemodialysis | 1g |
For penicillin allergy (severe) or MRSA positive patients: gentamicin 3mg/kg iv
ERCP (Endoscopic Retrograde Cholangio- Pancreatography): High risk cases
Antibacterials NOT routinely required for ERCP
When complete biliary drainage is unlikely to be achieved AND for sclerosing cholangitis: ciprofloxacin 750mg po
For cases already being treated for cholangitis: continue treatment antibiotics