- Clean wounds with sterile normal saline
- Ensure that tetanus prophylaxis status is up to date
- Consult Infectious Diseases service for rabies prophylaxis in settings of wild animal bites or in geographic areas with high prevalence of rabies
- Generally, 5-10 days of therapy is sufficient in the absence of complications (e.g. septic arthritis, osteomyelitis, subcutaneous abscess, tendonitis)
Useful links for rabies
https://www.ontario.ca/page/rabies
https://www.hamilton.ca/public-health/health-professionals/rabies-reporting-vaccines
Animal Bites
Common pathogens: Pasteurella species, Staphylococci, Streptococci species, anaerobes (Bacteroides species, Fusobacterium species, Porphyromonas species, Proprionibacteria and Peptostreptococci)
Treatment Options
Mild infection
Amoxicillin/clavulanic acid 875/125mg po BID
In cases of severe beta lactam allergy:
Levofloxacin 500-750mg po daily + metronidazole 500mg po BID (HHS only)
OR Moxifloxacin 400mg po daily (SJHH only)
In Situations Where Intravenous Therapy is Required
Ceftriaxone 2g IV daily + metronidazole 500mg IV / po BID
OR
Piperacillin-tazobactam 4.5g IV q8h
Human Bites
Common pathogens: Streptococci species, Staphylococci, Haemophilus species, Eikenella corrodens
Treatment Options
Mild Infection
Amoxicillin clavulanic acid 875/125mg po BID
In cases of severe beta-lactam allergies:
Levofloxacin 500-750mg po daily + metronidazole 500mg po BID (HHS only)
OR
Moxifloxacin 400mg po daily (SJHH only)
OR
Septra 8-10mg/kg/DAY of trimethoprim component in 2 divided doses (please refer to document titled Trimethoprim-Sulfamethoxazole Weight-Based Dosing Tables for IV or PO) + metronidazole 500mg po BID
In Situations Where Intravenous Therapy is Required
Ceftriaxone 2g IV daily + metronidazole 500mg IV / po BID
OR
Piperacillin-tazobactam 4.5g IV q8h