Mammalian bites

Background

• 5% of untreated dog bites will become infected (similar to rate of non-bite wounds)
• 80% of untreated cat bites will become infected

Indications for Primary Closure of Mammalian Bites

• Consider closure if all of the following are true:

1. Not a face or scalp wound
2. Repair can occur within 6hr of injury (time dependent upon individual judgment)
3. Repair only requires single-layer closure; no devitalized tissue
4. No underlying fracture
5. No systemic immunocompromising conditions

High-Risk Wounds

1. Cat, human, livestock, or monkey bites
2. Deep puncture wounds
3. Hand or foot wounds
4. Bites in immunosuppressed patients

Treatment

Antibiotics

• Consider for high-risk wounds (see above)

Mamallian bites:

• Amoxicilin-clavulanate 875mg PO BID x 5-7d
• Doxycycline 100mg daily x 14 days <ref>Talan DA, Citron DM, Abrahamian FM, Moran GJ, Goldstein EJ. Bacteriologic analysis of infected dog and cat bites. Emergency Medicine Animal Bite Infection Study Group. N Engl J Med. 1999;340:85–92.</ref

Fish bites:

• Fluoroquinolone (for Vibrio coverage)
• Rabies immune globulin should be inidividualized
  • Indicated for bites from bats, monkeys, skunks, raccoons, foxes. In the U.S. rare for dog and cat bites

See Also

• Laceration Repair
• Closed Fist Infection