From the Guidelines
For cat scratch wounds on the hands, immediately wash the area thoroughly with soap and warm water for at least 5 minutes to remove bacteria, and consider azithromycin treatment as recommended by the Infectious Diseases Society of America 1. When managing cat scratch wounds, it's essential to prioritize prevention of infection.
- Wash the area with soap and warm water for at least 5 minutes to remove bacteria.
- Apply an antiseptic like povidone-iodine or hydrogen peroxide, then cover with a clean bandage.
- For minor scratches, apply an over-the-counter antibiotic ointment like Neosporin or Polysporin 3 times daily for 3-5 days.
- Monitor the wound for signs of infection, including increasing redness, swelling, warmth, pus, red streaks extending from the wound, or fever. According to the guidelines, azithromycin is recommended for cat scratch disease with a dosing protocol of 500 mg on day 1 followed by 250 mg for 4 additional days for patients >45 kg, and 10 mg/kg on day 1 and 5 mg/kg for 4 more days for patients <45 kg 1. It's crucial to seek medical attention if symptoms of infection develop, as cat scratches can cause infections, including Cat Scratch Disease from Bartonella henselae bacteria 1.
- Hand infections are particularly concerning due to the complex anatomy and potential for rapid spread.
- If the scratch is deep, bleeding heavily, or if you haven't had a tetanus shot in the last 5 years, see a healthcare provider.
- People with weakened immune systems should be especially vigilant about seeking prompt medical care for cat scratches.
From the FDA Drug Label
Directions adults and children 2 years of age and older: clean the affected area apply a small amount of this product (an amount equal to the surface area of the tip of a finger) on the area 1 to 3 times daily may be covered with a sterile bandage children under 2 years of age: ask a doctor
For a cat scratch involving the hands, the treatment involves:
- Cleaning the affected area
- Applying a small amount of bacitracin (TOP) on the area, 1 to 3 times daily
- The affected area may be covered with a sterile bandage For children under 2 years of age, it is recommended to ask a doctor 2
From the Research
Treatment of Cat Scratch Involving Hands
- The treatment of cat scratch disease, which can involve hands, typically depends on the severity of the infection and the patient's overall health 3, 4, 5, 6.
- In most cases, cat scratch disease is a self-limited illness that does not require antibiotic therapy, and symptoms can resolve on their own within a few weeks 3, 4, 5.
- However, for patients with severe or persistent cases, antibiotic therapy may be necessary, and several antibiotics have been shown to be effective, including:
- Azithromycin, which has been shown to speed recovery in one small study 5.
- Rifampin, ciprofloxacin, gentamicin, trimethoprim and sulfamethoxazole, clarithromycin, which have been shown to have greatest clinical efficacy in treating cat scratch disease 3.
- Erythromycin and doxycycline, which have also been used to treat severe or persistent cases 4.
- It's worth noting that one study found that 14 commonly used antibiotics were judged to be of little or no value in treatment of cat scratch disease, while four antimicrobials (rifampin, ciprofloxacin, trimethoprim-sulfamethoxazole, and gentamicin sulfate) were found to be efficacious 6.
- The study from 1975 7 is not relevant to the treatment of cat scratch disease involving hands.