9
Preemptive Antimicrobial Therapy to Prevent Infection
for Dog or Cat Bites
Î Preemptive early antimicrobial therapy for 3-5 days is recommended
for patients who:
a) are immunocompromised;
b) are asplenic;
c) have advanced liver disease;
d) have preexisting or resultant edema of the affected area;
e) have moderate to severe injuries, especially to the hand or face; or
f ) have injuries that may have penetrated the periosteum or joint capsule (SR-L).
Î Postexposure prophylaxis for rabies may be indicated. Consultation
with local health officials is recommended to determine if vaccination
should be initiated (SR-L).
Infected Animal Bite-related Wounds
Î An antimicrobial agent or agents active against both aerobic and
anaerobic bacteria such as amoxicillin-clavulanate should be used
(SR-M).
Î Tetanus toxoid should be administered to patients without toxoid
vaccination within 10 years. Tdap is preferred over Td if the former
has not been previously given (SR-L).
Primary Wound Closure for Animal Bite Wounds
Î Primary wound closure is NOT recommended for wounds, with the
exception of those to the face, which should be managed with copious
irrigation, cautious debridement and preemptive antibiotics (SR-L).
Other wounds may be approximated (WR-L).
Cutaneous Anthrax
Î Oral penicillin V 500 mg qid for 7-10 days is the recommended
treatment for naturally acquired cutaneous anthrax (SR-H).
Î Ciprofloxacin 500 mg PO bid or levofloxacin 500 mg IV/PO q24h
for 60 days is recommended for bioterrorism cases because of
presumed aerosol exposure (SR-L).
