Animal Bite-associated Infections

Microbiology and Treatment

Nicole Thomas; Itzhak Brook

Expert Rev Anti Infect Ther. 2011;9(2):215-226.

Five-year View

Performance of controlled studies that will assess the optimal antimicrobial therapy of bite wound infections in the face of antimicrobial resistance will be conducted over the next 5 years.

Development of improved laboratory testing to rapidly determine the identity and antimicrobial susceptibility of organisms associated with bite wounds, especially anaerobic pathogens should also be achieved in the coming years. Also in the future, continued effort to provide worldwide vaccination against tetanus and further emphasis on education to promote the prevention of bites, and the need for immediate medical assessment after being bitten, will be priorities.

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Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.

Cite this: Animal Bite-associated Infections - Medscape - Feb 01, 2011.

Table 1. Microbiology and antimicrobial therapy of bite infections.
Animal	Organism	Empiric antibiotic therapy
Human	Eikenella corrodens Viridans Streptococci Staphylococus aureus Coagulase-negative Staphylococus Corynebacterium Bacteroides Peptostreptococcus Hepatitis B/C HIV	Oral Amoxicillin/clavulanate (Augmentin®, GlaxoSmithKline, Brentford, UK) OR Moxifloxacin (only suitable for patients >18 years of age) Intravenous Ampicillin/sulbactam OR Piperacillin/tazobactam OR Cefoxitan OR Ertapenem PCN allergic Moxifloxacin (only suitable for patients >18 years of age); Doxycycline (only suitable for patients >8 years of age) OR Metronidazole or clindamycin PLUS Trimethoprim/sulphamethoxazole OR Another fluoroquinolone (ciprofloxacin/levofloxacin)
Dog	S. aureus/intermedius Pasteurella canis/multocida Capnocytophaga canimorsus Streptococcus spp. Moraxella spp. Clostridium spp. Bacteroides Fusarium	Same as human
Cat	Pasteurella multocida Streptococcus spp. (especially S. pyogenes) S. aureus Moraxella spp. Fusobacterium Bacteroides Porphyromonas	Same as human
Nonhuman primates	Mixed flora (aerobic/anaerobic) Streptococcus spp. Neisseriae spp. Haemophilus influenzae Enterobacteriaceae Simian Herpes B	Same as human + Valacyclovir
Rodents	Streptobacillus moniliformis Spirillum minus Salmonella spp. Staphylococcus Leptospira Pasteurella Corynebacterium Fusobacterium	Same as human
Ungulates	Polymicrobial Actinobacillus spp. Pasteurella spp. Staphylococcus spp. Viridans Streptococci (Streptococcus equi)	Same as human
Reptiles (i.e., crocodiles/alligators)	Aeromonas hydrophila Pseudomonas Proteus vulgaris Enterobacter Citrobacter Burkholderia Serratia spp. Mixed anaerobes	Ceftazadime + PCN + metronidazole OR Ceftriaxone + doxycycline + metronidazole
Marine organisms fish	Vibrio spp. Mycobacterium marinum Erysipilothrix rhusiopathiae Aeromonas hydrophila	Doxycycline OR Ciprofloxaxin OR Third-generation cephalosporin OR Extended-spectrum penicillin

PCN: Penicillin.
Data taken from [28].

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Animal Bite-associated Infections

Microbiology and Treatment

Five-year View

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