General principles

There is no evidence to support the use of antibiotic prophylaxis for patients undergoing routine upper or lower gastrointestinal endoscopy.

Prophylaxis against enterococcal endocarditis is indicated for patients with specific cardiac conditions (see here) who are undergoing gastrointestinal endoscopic procedures for which surgical antibiotic prophylaxis is required. If the surgical antibiotic prophylaxis regimen does not include an antibiotic active against enterococci (eg amoxicillin, ampicillin, vancomycin), see Endocarditis prophylaxis for genitourinary and gastrointestinal tract procedures for appropriate add-on recommendations.

Prophylaxis against enterococcal endocarditis may also be required for patients with specific cardiac conditions (see here) who are undergoing gastrointestinal endoscopic procedures for which surgical antibiotic prophylaxis is not required, if the patient has an established gastrointestinal infection—see Endocarditis prophylaxis for genitourinary and gastrointestinal tract procedures.