PROPHYLACTIC ANTIBIOTICS IN ENDOSCOPY OF THE DIGESTIVE-TRACT

The increasing use of endoscopy in diseases of the digestive tract has been associated with an increase in complications related to is technique. Because of this, various authors have recommended the administration of prophylactic antibiotics in an attempt to avoid infectious complications. This attitude has however been largely empirical, without a real assessment of the benefits and disadvantages. Although no prospective study has shown any clear benefit, it is generally accepted that prophylactic antibiotics should be given systematically whenever a digestive endoscopy is to be performed in a patient with a cardiac valvular disease or a history of bacterial endocarditis. Apart from these situations, prophylactic antibiotics may be indicated for sclerotherapy of actively bleeding oesophageal varices and prior to colonoscopy in immunodepressed patients or in those with an inflammatory disease of the colon.