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HWN Suggests

Culture that Infected Cat Bite (and Give Antibiotics)

It is generally agreed that amoxicillin-clavulanic acid (Augmentin) is a reasonable empiric single choice for treating cat bites in outpatients. P. multocida should be suspected for those who have had an early onset of infection. Amoxicillin-clavulanate would be effective, but so would alternatives such as penicillin and an extended spectrum quinolone, TMP/SMX, or tetracycline. It is my experience, however, that only a single antibiotic is usually prescribed, often only penicillin, and that seems to be effective. The literature suggests adding metronidazole to single outpatient antibiotics except amoxicillin-clavulanate, but I don't think this is often done in clinical practice. Note that…

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 Antibiotics

Augmentin 875/125 mg orally twice daily or 500/125mg three times daily x 7 days OR Ceftin (cefuroxime oral) 500mg orally twice daily OR Doxycycline 100mg orally twice daily OR moxifloxacin (Avelox) 400mg PO once daily x 7 days. CAT-SCRATCH DISEASE: Adults: Azithromycin 500 mg orally x 1, then 250 mg orally qd x 4 days OR Bactrim DS orally twice daily x 5 days

Articles of Interest

Bite injuries: Bark for Dogmentin

Feline bites have a much higher risk for puncture wounds and injecting bacteria deep into a wound. In the hand or foot this can put the patient at high risk for osteomyelitis or septic arthritis.

Cat, Dog and Other Bites

As a rule, cat and dog bite wounds should be treated and left open initially. This is true if they are punctures, if the bites are not potentially disfiguring, if they only involve the arms or legs (including the hands or feet) or if the bites to such areas occurred more than 6-12 hours earlier (because the bacteria would be closed into the wound). An exception to the open-wound treatment involves cuts to the face from cat or dog bites. Facial wounds are almost always closed to avoid disfigurement.

Mammalian Bites: ED presentations, evaluation, and management

Augmentin is the oral antibiotic of choice for both prophylaxis and treatment of infected mammalian bites.

Man With Cat Bite

Pyomyositis with pyogenic arthritis. Pyomyositis is a collection of purulent material in the skeletal muscle, commonly occurring in the setting of systemic immunodeficiency, intravenous drug abuse, concurrent infection, or trauma. Although the majority of cases are due to Staphylococcus aureus, our patient’s traumatic inoculation was determined to be from oral cat flora.

Rapidly Progressive Infection of Hand After a Cat Bite

Although dogs perpetrate the majority of animal bites, cat bites are responsible for three-quarters of bites that result in infection. Cat bites are easily underestimated because of the minimal appearance of tissue injury.

Resident Clinical Pearl – Animal Bites

Animal bites, like other wounds, require regular wound care with a focus on meticulous cleaning. Cat bites usually need prophylactic antibiotics, dogs usually do not. All immunocompromised hosts get prophylactic antibiotics

When your best friend bites: A note on dog and cat bites

Most experts currently recommend prophylactic antibiotics for the following situations only: bites with a high risk of infection, such as deep punctures caused by cats; wounds that require surgical repair; attacks involving immunocompromised hosts; and bites involving the hands or face.