From the Guidelines
For human bite infections, the best antibiotic is typically amoxicillin-clavulanate (Augmentin) at a dose of 875/125 mg taken orally twice daily for 5-7 days. This recommendation is based on the most recent and highest quality study available, which suggests that amoxicillin-clavulanate provides broad-spectrum coverage against the complex mixture of oral bacteria introduced by human bites, including Streptococcus species, Staphylococcus aureus, Eikenella corrodens, and various anaerobes 1. The study, published in the Clinical Infectious Diseases journal in 2014, recommends amoxicillin-clavulanate as the first-line treatment for human bite infections due to its effectiveness against a wide range of pathogens 1.
Some key points to consider when treating human bite infections include:
- Thoroughly cleaning the wound with soap and water to reduce the risk of infection
- Considering tetanus prophylaxis if the patient's immunization status is not up to date
- Evaluating the need for surgical intervention, especially for deep or puncture wounds on the hands
- Starting treatment promptly, ideally within 24 hours of the bite, to prevent rapid progression of the infection
For patients with penicillin allergies, alternative treatments may include clindamycin plus either ciprofloxacin or trimethoprim-sulfamethoxazole, as suggested by the study 1. However, it is essential to note that the bacteriology of human bite wounds can be complex, and empirical therapy may not always cover all potential pathogens. Therefore, amoxicillin-clavulanate remains the preferred first-line treatment due to its broad-spectrum coverage and effectiveness against a wide range of bacteria 1.
From the Research
Antibiotic Options for Human Bites
- Amoxicillin-clavulanate is considered one of the best options for treating human bites, as it provides broad-spectrum coverage against the bacteria commonly found in these types of infections 2.
- Moxifloxacin is also effective against the bacteria that cause human bite infections, including Staphylococcus aureus and Eikenella corrodens 2, 3.
- The choice of antibiotic may depend on the severity of the infection and the presence of any underlying medical conditions.
Comparison of Antibiotic Efficacy
- A study comparing moxifloxacin and amoxicillin-clavulanate for the treatment of complicated skin and skin structure infections found that both antibiotics were effective, with similar clinical success rates 4.
- Amoxicillin-clavulanate was found to be highly active against Streptococcus pneumoniae, including penicillin-nonsusceptible strains, while moxifloxacin has a broad spectrum of activity against various bacterial pathogens 5, 6.
Considerations for Antibiotic Selection
- The selection of an antibiotic for the treatment of a human bite should be based on the severity of the infection, the presence of any underlying medical conditions, and the potential for antibiotic resistance 2, 5.
- Amoxicillin-clavulanate and moxifloxacin are both considered effective options for the treatment of human bite infections, but the choice of antibiotic may depend on the specific circumstances of the infection.