Antibiotics for Animal Bites
Animal Bites Antibiotic Therapy
Animal Bites .PDF
What are the complications?Wound infection is the most common complication of mammalian bites, occurring after 2-30% of dog bites, 15-50% of cat bites and 9-50% of human bites. This compares with 1-12% of non-bite wounds managed in A & A. Less frequent complications are tetanus, rabies, septicaemia, septic arthritis, peritonitis, meningitis and disfiguring wounds from severe “mauling “.
How should the wound be managed?
When are antibiotics appropriate?The top priority is to achieve satisfactory wound healing with a good cosmetic outcome. A recent Cochrane review found no evidence that antibiotic prophylaxis is effective after cat and dog bites, but it reduces the risk of infection after human bites.
PRODIGY recommends the use of prophylactic antibiotics for:
• Human bites where there has been clear penetration of the skin.
Prophylactic antibiotics are not usually needed if the wound is more than two days old and there are no signs of infection. Antibiotics are, of course, clearly appropriate and should be prescribed when the wound is clinically infected.
Animal Bites Treatment - AntibioticsThe following are currently recommended for immediate treatment of adults and for treating mild-to-moderate established infections.
• Co-amoxiclav is also the first choice agent for children , who are not hypersensitive to penicillin.
What about tetanus prophylaxis?PRODIGY recommends that tetanus immunisation status should be checked for all bite wounds. A total of five doses of the vaccine (at appropriate intervals) is considered to give lifelong immunity. Following a bite prophylaxis should be given as follows.
What about rabies?People who have been bitten or scratched by an animal overseas (or a bat in the UK) should wash the wound thoroughly with soap and water (even if vaccinated) and seek immediate medical attention. Even if the patient cannot get urgent attention while away, this should be sought on return, even if it is sometime after the event.
Are Hepatitis B, Hepatitis C or HIV significant concerns?All human bite injuries should be taken seriously and enquiry made into the risk status of the perpetrator. Blood-borne viruses are potentially transmissible by a human bite if the skin is broken. There have been a small number of cases where hepatitis has been transmitted through bites. Several studies have followed up people bitten by HIV-infected individuals; no one in these studies seroconverted. PRODIGY recommends that if there is any risk or genuine uncertainty the Public Health Department should be consulted urgently.
Summary• Otherwise healthy people only need antibiotics for human bites, where the skin is broken or for high-risk animal bites.
• People at risk of serious wound infection complications (diabetic, asplenic, cirrhotic or immunocompromised ) should also be given antibiotics after any bite .
• Oral Co-amoxiclav for seven days is the agent of choice for adults and children.
• If allergic to penicillin , prescribe oxytetracycline (or erythromycin) plus metronidazole (unless under 12 , pregnant or breast feeding)
Sources used - www.gov.gg