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 spp.
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.

Consult with local health department about rabies vaccination if rabies status unknown.

Prophylaxis in high risk patients or in high risk bite:
High risk patient = post splenectomy, immunocompromised, advanced liver disease/EtOH use disorder
High risk bite = deep tissue involvement (bone, tendon, joint etc.), penetrating injury (including most cat bites), bites on the hand, foot, genital 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