Curbside Consultation of the Colon: 49 Clinical Questions

Brooks D. Cash, MD, FACP, CDR, MC, USN

Question 43: What Should Be My Response To Patients Who Ask About Antibiotic Prophylaxis For Their Colonoscopies? If They Are Persistent, And Do Not Have An Indication, Is It Ok To Acquiesce? (continued)

Inku Hwang, MD

Gastrointestinal endoscopies are low-risk procedures for endocarditis or other infectious complications, and thus, for many of these procedures, including colonoscopies with and without biopsies, prophylactic antibiotics are generally not recommended. This is based on the low reported incidence of endocarditis and the lack of any clear benefit with prophylactic antibiotics. Adding to the arguments against antibiotic prophylaxis for colonoscopy are the facts that the bacteria that enter the blood during colonoscopy are not those typically associated with endocarditis, and the inappropriate use…