Daily Bolus of LR: Mammalian Bites

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July 15, 2011 by dailybolusoflr

Mammalian Bites

Human Bites:

· Bacteroides, Eikenella, Staph, Strep and Corynebacterium

· All human bites should receive prophylaxis with antibiotics

o (Cochrane review states “There is evidence from one trial that prophylactic antibiotics reduces the risk of infection after human bites but confirmatory research is required”)

· Amoxicillin/clavulanate is the 1st line drug

· Irrigation and debridement of any devitalized tissue is essential even for uncomplicated wounds to prevent infection

· Hand bites are at high risk

· Remember fight bites when someone comes in with a lac to their hand after punching someone else!

Dog and Cat Bites:

· Cat bites have higher rates of infection than dog bites (see prior daily bolus for cat bites)

· Dog bites have the lowest rate of infection of all human, dog or cat

· Antibiotic prophylaxis is NOT recommended for simple soft tissue bites; however many clinicians choose to treat bites to the hand (there is no evidence to support this- Cochrane Review 2003)

· Again, irrigation and debridement of any devitalized tissue is essential even for uncomplicated wounds to prevent infection

· If patients come in with infection, amoxicillin/clavulanate is the 1st line drug for treatment

Ref: Cochrane Review 2003; Tintinalli

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