Bacteremia during barium enema study

The occurrence of bacteremia was studied in patients undergoing barium enema. Blood cultures were done on 34 patients before, during, and after the procedure using two schedules. Cultures were obtained once during the procedure in the first schedule and four times in the second. None of the cultures were positive by the first schedule, while 23% of patients studied by the second schedule had one or more positive cultures. Organisms isolated were anaerobes. The bacteremia was transient and self-limited, without serious clinical sequelae. The incidence of bacteremia during barium enema examination was statistically indistinguishable from bacteremia previously reported during colonscopy. It is concluded that antibiotic prophylaxis is not indicated in most patients undergoing colonic diagnostic procedures. Prophylaxis in selected high-risk patients requires further study.
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