| Patient condition | Procedure contemplated | Antibiotic prophylaxis |
| High risk: | ||
| Prosthetic heart valve or prosthetic material used for valve repair History of endocarditis Unrepaired cyanotic congenital heart disease (including palliative shunts and conduits) Repaired congential heart disease with residual defects at the site of or adjacent to a prosthetic device Completely repaired congenital heart defects with prosthetic material or device during the first six months after the repair Cardiac valvulopathy in a transplanted heart | Stricture dilation Variceal sclerotherapy ERCP/obstructed biliary tree | Not recommended |
| Other endoscopic procedures, including EGD and colonoscopy (with or without biopsy/polypectomy), variceal ligation | Not recommended | |
| Moderate risk: | ||
| Most other congenital abnormalities Acquired valvular dysfunction (eg, rheumatic heart disease) Hypertrophic cardiomyopathy Mitral valve prolapse with regurgitation or thickened leaflets | Esophageal stricture dilation Variceal sclerotherapy | Not recommended |
| Other endoscopic procedures, including EGD and colonoscopy (with or without biopsy/polypectomy), variceal ligation | Not recommended | |
| Low risk: | ||
| Other cardiac conditions (CABG, repaired septal defect or patent ductus, mitral valve prolapse without valvular regurgitation, isolated secundum atrial septal defect, physiologic/functional/innocent heart murmurs, rheumatic fever without valvular dysfunction, pacemakers, implantable defibrillators) | All endoscopic procedures | Not recommended |
| Obstructed bile duct without cholangitis | ERCP with complete drainage | Not recommended |
| Obstructed bile duct with cholangitis | ERCP with anticipated incomplete drainage | Recommended (continue antibiotics after procedure) |
| Pancreatic cystic lesion | ERCP, EUS-FNA | Recommended |
| Cirrhosis acute gastrointestinal bleed (required for patients with or without endoscopic procedures) | All endoscopic procedures | Recommended |
| Ascites, immunocompromised patient | Stricture dilation Variceal sclerotherapy Other endoscopic procedures, including EGD and colonoscopy (with or without biopsy/polypectomy), variceal ligation | No recommendation |
| All patients | Percutaneous endoscopic feeding tube placement | Recommended (parenteral cephalosporin or equivalent) |
| Vascular graft | AHA: Recommended antibiotic usage within 6 months of procedure ASGE: Antibiotics not recommended | |
| Prosthetic joints | All endoscopic procedures | Not recommended |
