Animal Bite-associated Infections

PCN: Penicillin.
Data taken from [28].

Authors and Disclosures

Nicole Thomas¹ and Itzhak Brook<sup>†2

1</sup>USAF, Fellow Pediatric Infectious Diseases, National Capitol Consortium 4301 Jones Bridge Road, Bethesda, MD 20814, USA
²Department of Pediatrics, Georgetown University School of Medicine, Washington, DC, USA

^†Author for correspondence
Tel.: +1 202 744 8211 Fax: +1 612 233 0806 ib6@georgetown.edu%20ss

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Key Issues

• Bite wounds may develop into deep-seated infections, and may disseminate systemically. Host factors (especially immune status of the patient) may contribute to complications ranging from cellulitis and osteomyelitis to life-threatening infections such as endocarditis or intracranial abscess.

• Bite wound infections are generally polymicrobial due to aerobic and anaerobic organisms. Therapy should provide coverage for both types of pathogens.

• Many animal species carry a unique bacterial and viral oral flora that requires specific empirical therapy. Examples include Eikenellain humans, herpes B virus in monkeys, Pasteurellain cats and dogs, Capnocytophagain dogs, Actinobacillusin pigs and horses, and Aeromonasin alligators.

• Amoxicillin/clavulanate is considered the standard oral agent to empirically treat mammalian bite wound infections. Moxifloxacin may be considered as an effective single-drug regimen in individuals over 18 years of age (especially if they are penicillin allergic).

• Rabies prophylaxis is an important consideration in all individuals who are bitten by a mammal capable of spreading the virus. New CDC guidelines have decreased the number of rabies postexposure vaccine injections from five to four doses.

• Thorough cleaning with debridement (if necessary), and evaluation to include determination of tetanus vaccine status and radiologic studies are crucial components of bite wound management.