🦷🐕 Animal and human bites carry a high risk of infection and demand careful management. Immediate and thorough wound cleaning + appropriate antibiotics (for high-risk cases) are essential to prevent serious complications. ⚠️ Human bites are especially dangerous, requiring added considerations such as HIV and hepatitis B prophylaxis. Close wound monitoring and early antibiotic treatment reduce the risk of sepsis and long-term disability.

🐕 Animal Bites

🚿 Rabies concern: Scrub wound with soap + water for at least 15 minutes → rinse → apply disinfectant (e.g. povidone-iodine).
🦠 This reduces the risk of rabies, tetanus, and bacterial infection.
💉 Rabies PEP (post-exposure prophylaxis) is indicated based on exposure category and local epidemiology.

💊 Use of Antibiotics

While not always needed for low-risk bites, pre-emptive antibiotics (3–5 days) are recommended for:

🧬 Immunocompromised patients
🩸 Asplenic individuals
🍺 Advanced liver disease
💧 Significant oedema at the site
✋ Face or hand injuries (high cosmetic/functional risk)
🦴 Wounds penetrating periosteum or joint capsule

💊 Recommended Antibiotics for Animal Bites

1️⃣ First-line: Amoxicillin–Clavulanate (Augmentin) → covers Pasteurella, streptococci, staphylococci, anaerobes.
2️⃣ Penicillin allergy: Clindamycin + Ciprofloxacin (or Doxycycline) → anaerobic + aerobic cover.
3️⃣ Severe infections / hand/face bites: IV Piperacillin–Tazobactam or Ceftriaxone.

🧑 Human Bites

🚨 Always considered high risk due to oral flora (Eikenella, anaerobes, strep, staph). Common in fights (“clenched fist injury”), which can track infection into deep structures of the hand.

💊 Prophylactic antibiotics: Always indicated.
🧬 HIV PEP: Consider within 72h if bite involved blood exposure. Risk is low but not zero.
🦠 Hepatitis B: Give vaccine ± HBIG within 24h if unimmunised/exposed.
💉 Tetanus prophylaxis as per immunisation status.

💊 Recommended Antibiotics for Human Bites

1️⃣ First-line: Amoxicillin–Clavulanate.
2️⃣ Penicillin allergy: Clindamycin + Ciprofloxacin/Doxycycline.
3️⃣ Deep wounds / severe infection: IV Piperacillin–Tazobactam or Ceftriaxone.

🛠️ Wound Management Principles

🚫 Do NOT primarily suture bite wounds → high infection risk. Leave open, irrigate, dress.
✅ Delayed primary closure possible at 72h if no infection develops.
🔍 Examine wound daily for erythema, pus, spreading cellulitis.
⬆️ Elevate affected limb (sling for upper limb, stockinet support for lower limb).
🦠 If infection develops → escalate to IV antibiotics, surgical debridement if needed.

📌 Summary

🦷🐕 Bite wounds are dirty wounds by definition. Key steps: 🚿 clean thoroughly → 💉 update tetanus/rabies/HBV as needed → 💊 give antibiotics for high-risk or all human bites → 🔍 monitor closely. Management must balance infection risk, cosmetic outcome, and function.

The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms.

Management of Bites