Environmental exposure antibiotics

Mammalian bites

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[1], violation of bone or joint capsule, immunocompromised hosts, wounds associated with significant local edema
  • Amoxicilin-clavulanate 875mg PO BID x 5-7 days OR[2]
  • Doxycycline 100mg PO daily x 14 days if penicillin allergic [3]
  • Clindamycin 450mg (5mg/kg) PO q8hrs daily x7 days PLUS

Human Bites

All human bites should be strongly considered for antibiotic therapy.[4]

Requires polymicrobial coverage for: S. aureus, Strep Viridans, Bacteroides, Coagulase-neg Staph, Eikenella, Fusobacterium, Cornebacterium, Peptostreptococcus

Mammalian Bites Severe Infections

Tetanus (Acute)

Penicillin

  • Although once the drug of choice it is now no longer recommended since it may potentiate the effect of tetanus toxin by inhibiting the GABA receptors[5]

See Also

Antibiotics by diagnosis

For antibiotics by organism see Microbiology (Main)

References

  1. EBQ:Antibiotic prophylaxis for mammalian bites
  2. Griego RD, Rosen T, Orengo IF, Wolf JE. Dog, cat, and human bites: a review. J Am Acad Dermatol. 1995;33:1019–29.
  3. 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.
  4. EBQ:Antibiotic prophylaxis for mammalian bites
  5. Ganesh Kumar AV. Benzathine penicillin, metronidazole and benzyl penicillin in the treatment of tetanus: a randomized, controlled trial .Ann Trop Med Parasitol. 2004 Jan;98(1):59-63 PMID 15000732