Other Procedures and Endocarditis Prophylaxis

• Respiratory tract
  • Tonsillectomy and/or adenoidectomy
  • Surgical procedures that involve respiratory mucosa
  • Bronchoscopy with a rigid bronchoscope
• Gastrointestinal Tract¹
  • Sclerotherapy for esophageal varices
  • Esophageal stricture dilation
  • Endoscopic retrograde cholangiography with biliary obstruction
  • Biliary tract surgery
  • Surgical procedures that involve intestinal mucosa
• Genitourinary tract
  • Prostatic surgery
  • Cystoscopy
  • Urethral dilation

• Respiratory Tract
  • Endotracheal intubation
  • Bronchoscopy using a flexible bronchoscope, with or without biopsy²
  • Tympanostomy tube insertion
• Gastrointestinal Tract¹
  • Transesophageal echocardiography²
  • Endoscopy with or without gastrointestinal biopsy²
• Genitourinary Tract
  • Vaginal hysterectomy²
  • Vaginal delivery²
  • Caesarean section
• In uninfected tissue:
  • Urethral catheterization
  • Uterine dilatation and curettage
  • Therapeutic abortion
  • Sterilization procedures
  • Insertion or removal of intrauterine devices
• Other procedures
  • Cardiac catheterization, including balloon angioplasty
  • Implanted cardiac pacemakers, implanted defibillators, and coronary stents
  • Incision or biopsy of surgically scrubbed skin
  • Circumcision
    

1. Prophylaxis is recommended for high-risk patients and is optional for medium-risk patients.
2. Prophylaxis is optional for high-risk patients.

Adapted from Danjani AS, Taubert KA, Wilson W, et al. Prevention of Bacterial Endocarditis. Recommendations by the American Heart Association. JAMA. 1997;277:1794-1801. Copyright 1997, American Medical Association.