Important: Therapy
Co-amoxiclav oral 625mg 8 hourly
Human and Animal Bites
Duration
3 days for prophylaxis
5 days for treatment (course length can be increased to 7 days with review based on clinical assessment of the wound)
Important: Therapy
Doxycycline oral 100mg every 12hours
+
Metronidazole oral 400mg 8 hourly
Important: Therapy
Erythromycin oral 500mg every 12 hours
+
Metronidazole oral 400mg 8 hourly
and seek specialist advice
Important: Notes
Consult Microbiologist if animal species is other than a dog or a cat.
Consider antimicrobial prophylaxis for the following: human bites, bites to the hand, foot or face, deep/puncture wounds, wounds requiring surgical debridement, bites to high risk patients e.g. diabetics, immunocompromised, prosthetic valve. The choice of antimicrobial for prophylaxis is the same as used for treatment.
For management of high risk tetanus prone wounds discuss with Consultant Microbiologist.
Rabies
There is currently deemed to be no risk from rabies from contact with terrestrial mammals (other than imported animals) in the UK. Bats in the UK may carry rabies-like viruses and contact with them needs to be assessed. Scottish Health Protection Network guidance is currently being updated. In the meantime Public Health England guidance is available on this site:
https://www.gov.uk/government/publications/rabies-post-exposure-prophylaxis-management-guidelines
Details on rabies risk in different countries can be found at