July 17, 2014

Animal bites are a common cause of injury in the United States. About 4.5 million Americans/year (5% of all traumatic wounds in the ED) will sustain a bite injury. Dog bites compromise a majority of these wounds. The classic teaching is that dog bites should not be closed primarily and they should all be prophylactically treated with antibiotics. When dog bites become infected, Pasteurella species, specifically P. canis, are the most common pathogens. Amoxicillin-clavulanate (AKA “dog-mentin”) is the antibiotic of choice. It’s also important to keep in mind that Emergency Department repaired lacerations (not just dog bites but all comers) have a 3-7% infection rate. As usual, the dogma (pun intended) is based on minimal if any evidence. Additionally, there are some recent articles that are relevant to the discussion that should be discussed.

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