We had an excellent morning report presentation by Sachin yesterday. One of the many questions that came up was: Should prophylactic antibiotics be given before ERCP?
I did run this by GI, and also received some input from our PD. The answer is, prophylactic antibiotics should be given in selected cases. According to ACGE in 2008:
Antibiotic prophylaxis should be considered before an ERCP in patients with known or suspected biliary obstruction, in which there is a possibility that complete drainage may not be achieved at the ERCP… … Antibiotic prophylaxis is not recommended in patients with biliary obstruction when it is likely that an ERCP will accomplish complete biliary drainage.
I don’t know if there is newer evidence since 2008. Another condition that qualify for prophylactic antibiotics is ascending cholangitis. Full text available here.