Bites

Patient Population: Adult

Diagnosis	Common Pathogens	Drug(s) of First Choice	Alternative Drug(s)	Comments	Expected Duration
Bites	Dog/cat: Streptococci Pasteurella spp.* Staphylococci Oral anaerobes Human: Viridans streptococci Eikenella* Oral anaerobes	Amoxicillin/ clavulanate 875mg/125mg PO BID	For severe beta-lactam allergy: Clindamycin PLUS EITHER (Ciprofloxacin or Levofloxacin)	Only 5% of dog bites become infected, whereas 30-50% of cat bites become infected. Evaluate tetanus vaccine history and administer if indicated Prophylaxis in high risk patients or in high risk bite only: High risk patient = post splenectomy, immunocompromised High risk bite = hand, foot, or face	Prophylaxis: 5 days Treatment: 10 days

Diagnosis

Common Pathogens

Drug(s) of First Choice

Alternative Drug(s)

Comments

Expected Duration

Bites

Dog/cat:
Streptococci
Pasteurella spp.*
Staphylococci
Oral anaerobes

Human:
Viridans streptococci
Eikenella*
Oral anaerobes

Only 5% of dog bites become infected, whereas 30-50% of cat bites become infected.

Evaluate tetanus vaccine history and administer if indicated

Prophylaxis in high risk patients or in high risk bite only:
High risk patient = post splenectomy, immunocompromised

High risk bite = hand, foot, or face

Prophylaxis: 5 days

Treatment: 10 days

Clinical Infectious Diseases, Volume 59, Issue 2, 15 July 2014, Pages e10–e52, https://doi.org/10.1093/cid/ciu296

Infectious Diseases Management Program at UCSF