21
Table 4. Recommended Therapy for Infections after Animal
or Human Bites
Antimicrobial Agent by Type of Bite
Oral Intravenous Comments
Animal Bite
Amoxicillin/
clavulanate
875/125 mg bid … Some Gram-negative rods
are resistant; misses MRSA
Ampicillin-
sulbactam
… 1.5-3.0 g q6-8h Some Gram-negative rods
are resistant; misses MRSA
Piperacillin/
tazobactam
… 3.37 g q6-8h Misses MRSA
Carbapenems … See individual info. Misses MRSA
Doxycycline 100 mg bid 100 mg q12h Excellent activity against
Pasteurella multocida; some
streptococci are resistant
Penicillin plus
dicloxacillin
500 mg qid/
500 mg qid
…
SMX/TMP 160-800 mg bid 5-10 mg/kg/day
of TMP
component
Good activity against
aerobes; poor activity
against anaerobes
Metronidazole 250-500 mg tid 500 mg q8h Good activity against
anaerobes; no activity
against aerobes
Clindamycin 300 mg tid 600 mg q6-8h Good activity against
staphylococci, streptococci
and anaerobes; misses
P. multocida
Second-generation cephalosporin Good activity against P.
multocida; misses anaerobes
Cefuroxime 500 mg bid 1 g q12h
Cefoxitin … 1 g q6-8h
ird-generation cephalosporin
Ceriaxone … 1 g q12h
Cefotaxime … 1-2 g q6-8h
Fluoroquinolones Good activity against P.
multocida; misses MRSA
and some anaerobes
Ciprofloxacin 500-750 mg bid 400 mg q12h
Levofloxacin 750 mg daily 750 mg daily
Moxifloxacin 400 mg daily 400 mg daily Monotherapy; good for
anaerobes also
