Cat bites
Background
- Over 400,000 cat bites are reported each year in the US.
- They are thought to under-reported.[1]
- 40 million households in the United States have domestic cats.[2]
Clinical Features
- Local injury - punctures marks from teeth.
- Pain
Antibiotics
Cat and Dog Bites
Coverage for Pasteurella, Strep, and Staph
- Consider for high-risk wounds
- wounds reaching the level of the muscle/tendon, wounds to the hand[3], violation of bone or joint capsule, immunocompromised hosts, wounds associated with significant local edema
- Amoxicilin-clavulanate 875mg PO BID x 5-7 days OR[4]
- Doxycycline 100mg PO BID x 14 days if penicillin allergic [5]
- Clindamycin 450mg (5mg/kg) PO q8hrs daily x7 days PLUS
- Ciprofloxacin 500mg PO q12hrs x 7 days OR
- TMP/SMX 2DS tabs (5mg/kg) PO q12hrs
Human Bites
All human bites should be strongly considered for antibiotic therapy.[6]
Requires polymicrobial coverage for: S. aureus, Strep Viridans, Bacteroides, Coagulase-neg Staph, Eikenella, Fusobacterium, Cornebacterium, peptostreptococus
- Amoxicilin-clavulanate 875mg PO BID x 5-7days OR
- Clindamycin 450mg (5mg/kg) PO q8hrs daily x7 days PLUS
- Ciprofloxacin 500mg PO q12hrs x 7 days OR
- TMP/SMX 2DS tabs (5mg/kg) PO q12hrs
Mammalian Bites Severe Infections
- Ampicillin/Sulbactam 3g IV (50mg/kg IV) q 6hrs daily OR
- Cefoxitin 1g IV q8hrs (25mg/kg q6hrs) OR
- Pipericillin/Tazobactam 4.5g IV (80mg/kg IV) q8hrs OR
- Ceftriaxone 1g (50mg/kg IV) once + Metronidazole 500mg IV q8hrs OR
- Clindamycin 600mg IV q8hrs PLUS
- TMP/SMX 5mg/kg IV q12hrs OR
- Ciprofloxacin 400mg IV q12hrs OR
Coverage for Pasteurella, Strep, and Staph. Consider coverage for ''Bartonella henselae'', (Hookworm) ''Ancylostoma tubaeforme'', ''Ancylostoma braziliense'', and ''Uncinaria stenocephalaand'' [7][8]
References
- ↑ "Prevent Bite Wounds". American Academy of Pediatrics. 2017. Retrieved June 17, 2017
- ↑ "Cats - Healthy Pets Healthy People - CDC". www.cdc.gov. Retrieved 18 June 2017. This article incorporates public domain material from websites or documents of the Centers for Disease Control and Prevention.
- ↑ EBQ:Antibiotic prophylaxis for mammalian bites
- ↑ Griego RD, Rosen T, Orengo IF, Wolf JE. Dog, cat, and human bites: a review. J Am Acad Dermatol. 1995;33:1019–29.
- ↑ 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.
- ↑ EBQ:Antibiotic prophylaxis for mammalian bites
- ↑ Maniscalco, K; Edens, MA (April 20, 2017). "Animal Bites". National Center for Biotechnology Information, U.S. National Library of Medicine. Retrieved June 17, 2017.
- ↑ Joanna Zajkowska, Monika Król, Daniel Falkowski, Norina Syed, Anna Kamieńska. "Capnocytophaga canimorsus - An Underestimated Danger After Dog or Cat Bite - Review of the Literature", Przegl Epidemiol. 2016;70(2):289-295. n.d.