Annual Meeting of the North American Society for Pediatric Gastroenterology and Nutrition; Orlando, October 22-24, 1998
ANTIBIOTIC PROPHYLAXIS FOR ENDOSCOPIC PROCEDURES: WHAT IS THE STANDARD IN NORTH AMERICA FOR CHILDREN?
PURPOSE. Few data exist on the efficacy of antibiotic prophylaxis for endoscopic procedures or on the frequency of prophylaxis. The American Heart Association (AHA) provides guidelines for low and high risk cardiac conditions and the American Society for Gastrointestinal Endoscopy (ASGE) provides guidelines primarily for adults with cardiac, orthopedic, biliary and pancreatic conditions. However, no guidelines are available for conditions like immunocompromise or the presence of a central venous line or ventriculo-peritoneal (V-P) shunt in children. To determine the standard of practice in North America, we surveyed 15 academic pediatric GI centers.
METHODS. Representatives of 3 Canadian and 12 US centers which perform a large volume of procedures completed questionnaires. Responses were compared for 5 conditions and 6 procedures: AHA/ASGE low-risk procedures - upper GI endoscopy (EGD) + biopsy, flexible sigmoidoscopy (FS) or colonoscopy (C) + biopsy; AHA/ASGE higher-risk procedures: esophageal sclerotherapy (ES), esophageal dilatation (ED), percutaneous endoscopic gastrostomy (PEG) placement and diagnostic endoscopic retrogradepancreatography (ERCP).
RESULTS. Few centers had specific protocols for antibiotic prophylaxis and most responses represent a consensus of endoscopists at these centers. The Table summarizes the results for the use of antibiotic prophylaxis.
There were no differences by the country or region of the centers.
CONCLUSIONS: The reported practices at these centers indicate that antibiotic prophylaxis is not used routinely in children for many procedures and conditions, including immunocompromise or presence of a central line or V-P shunt.
Intestine/Colon/IBD© 1998 Lippincott Williams & Wilkins, Inc.