Guidelines
Human or Animal Bite Wounds

Human or Animal Bite Wounds

Clinical/Diagnostic Considerations

General Principles

  • Clean wounds thoroughly with soap and water
  • Take wound and blood cultures
  • Hypo/asplenic patients can develop fulminant infections, especially with Capnocytophaga species
  • Follow-up patients  24-48 hours later with or without prophylaxis

Prophylactic antimicrobials for human or animal bites (including dogs, cats, rats, squirrels, reptiles, rodents etc.) as follows: 

  • Any rat bite, penetrating cat bite, severe animal bite
  • All penetrating human bite wounds
  • Immunocompromised patients, asplenic or liver disease
  • Bites of face or hand, penetrating joints or bone
  • Consider for any wounds undergoing primary closure

Wound Management:

  • Consider delayed closure 
  • Consultation with plastic surgery for face/hand wounds.

Other Considerations:

  • Consider Rabies immunization and human rabies immune globulin for dog, cat, ferret, skunks, racoons, bats, foxes or carnivore bites. Rodents generally do not transmit rabies. Consultation with local Public Health Unit is recommended.
  • All bite episodes represent an opportunity to review Hepatitis B and tetanus immunization status (and update/administer prophylaxis if necessary).

Most Likely Pathogens

Pasteurella spp. (cat and dog bites)

Anaerobes

S. aureus

Empiric Antimicrobials (Hospitalized)

In patients with a history of anaphylaxis to penicillin, clindamycin IV with Trimethoprim-Suphamethoxazole PO can be used for the same durations or consult ID.

Empiric Antimicrobials (Outpatient)

In patients with a history of anaphylaxis to penicillin, clindamycin PO with Trimethoprim-Suphamethoxazole PO can be used for the same durations.

Usual Duration

Prophylaxis: 3 days

Treatment of infection: 7 days if outpatients. Will need follow-up.

For infected wounds, therapy can be modified once cultures available. Severe or deep wounds or those associated with bacteremia may warrant longer durations. Consider consult with Infectious Disease.