Animal Bites and Human Bites

Micro-organism

Pastuerella multocida - animal

Staph.aureus, Strep.pyogenes, oral anaerobes - human

First Line

Co-amoxiclav PO for 5 days

If MRSA - ADD vancomycin IV

Second line: mild intolerance or mild skin reaction

Co-trimoxazole PO + Metronidazole PO for 5-7 days

If IV therapy required, Ceftriaxone IV + metronidazole IV for 5-7 days

If MRSA - add Vancomycin IV

Anaphylaxis (including severe skin reaction) to penicillin / cephalosporins

Co-trimoxazole PO + Metronidazole PO for 5-7 days

If IV therapy required, Vancomycin IV + gentamicin IV + metronidazole IV for 5-7 days

If MRSA - add Vancomycin IV

Notes

Consider risk of rabies if foreign travel or if bitten by bat. Discuss with microbiology.

Assess risk of tetanus, HIV, Hep B+C in human bites.

If immunocompromised or asplenic, seek senior advice.

If hand or tendon involved, consult with hand surgeon