Bite Wound

Animal Bites

  • Consider rabies immunization and immune globulin
  • Hypo/asplenic patients can develop fulminant infections, especially with Capnocytophaga species
  • Delayed closure (as opposed to early suturing) should be strongly considered as bite wounds are often deep, have devitalized tissue and are difficult to irrigate. Consultation with surgery may be appropriate.
  • Consider antimicrobial prophylaxis especially in face wounds, hand bites, penetrating cat bites, any moderate to severe bites from animals and for any wound that has been closed at first presentation.

Human Bites

Antibiotic prophylaxis is recommended for human bite wounds

All bite episodes represent an opportunity to review Hepatitis B and tetanus immunization status.
The transmission of blood borne pathogens (Hepatitis B, C and HIV) following a bite wound in children is extremely unlikely.

Post exposure prophylaxis for Hepatitis B is recommended if the exposure to blood or body fluids was from an index case known to be Hepatitis B antigen positive and the patient has not been previously immunized against Hepatitis B.

If there is a particularly high risk situation regarding HIV transmission, a pediatric infectious diseases expert may be consulted.

Most Likely Pathogens

P. multocida (cat and dog bites)

Anaerobes

S. aureus

Empiric Antimicrobials (Hospitalized)

Empiric Antimicrobials (Outpatient)

Usual Duration

3 days for prophylaxis

7 to 10 days for treatment

More severe cases or bite wounds associated with bacteremia may warrant longer durations. Consult Infectious Disease.