Endoscopic Submucosal Dissection-Associated Bacteremia: Proper Antibiotic Management

Area of Science:

• Gastroenterology
• Endoscopy
• Infectious Disease

Background:

• Endoscopic submucosal dissection (ESD) effectively treats early gastrointestinal cancers and precancerous lesions.
• ESD's complexity can lead to complications like perforation, increasing bacteremia risk.
• Bacteremia post-ESD is generally low (<5%), transient, and rarely causes severe infections.

Purpose of the Study:

• To analyze the risk of bacteremia following ESD across various digestive tract locations.
• To evaluate the necessity of antibiotic prophylaxis for ESD procedures.
• To provide a clinical reference for managing bacteremia risk in ESD.

Main Methods:

• Systematic literature search of PubMed, Embase, and Cochrane Library.
• Analysis of studies published up to January 2026.
• Narrative review focusing on bacteremia incidence and outcomes after ESD.

Main Results:

• The overall incidence of bacteremia after ESD is low.
• Bacteremia is typically transient and asymptomatic.
• Perforation during ESD increases the risk of bacteremia and potential complications.

Conclusions:

• While bacteremia after ESD is uncommon, understanding its risks is crucial.
• Further research is needed to define optimal antibiotic strategies.
• ESD remains a valuable endoscopic intervention with manageable complication risks.