What is the protocol for managing a cat bite?

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Last updated: May 9, 2025 • View editorial policy

From the Guidelines

Cat bites require immediate attention due to their high infection risk, and the standard antibiotic treatment is amoxicillin-clavulanate (Augmentin) 875/125 mg twice daily for 5-7 days, as recommended by the Infectious Diseases Society of America 1. The wound should be cleaned thoroughly with soap and water for at least 5 minutes, then apply an antiseptic like povidone-iodine. Seek medical care promptly, as most cat bites need professional evaluation. For penicillin-allergic patients, alternatives include clindamycin 300 mg four times daily plus either ciprofloxacin 500 mg twice daily or trimethoprim-sulfamethoxazole 160/800 mg twice daily 1. Some key points to consider when treating cat bites include:

  • Watching for signs of infection, including increasing redness, swelling, warmth, pain, or pus drainage
  • Recognizing that cat bites are particularly dangerous because their sharp, narrow teeth create deep puncture wounds that seal quickly, trapping bacteria inside
  • Understanding that Pasteurella multocida, a common bacteria in cats' mouths, can cause rapid infection within 24-48 hours
  • Being aware that bites to the hand, wrist, or over joints are especially concerning and may require surgical evaluation
  • Ensuring that tetanus vaccination is current (within 10 years), and in rare cases, rabies prophylaxis may be considered if the cat's vaccination status is unknown 2, 3, 4. It is essential to follow the guidelines for the diagnosis and management of skin and soft tissue infections, as outlined by the Infectious Diseases Society of America 1, to minimize the risk of morbidity, mortality, and to improve the quality of life for patients with cat bites.

From the Research

Cat Bite Protocol

  • Cleaning and irrigation: Bite wounds should be cleaned and copiously irrigated with normal saline using a 20-mL or larger syringe or a 20-gauge catheter attached to the syringe 5
  • Exploration: The wound should be explored for tendon or bone involvement and possible foreign bodies 5
  • Closure: Wounds may be closed if cosmetically favorable, such as wounds on the face or gaping wounds 5
  • Antibiotic prophylaxis: Antibiotic prophylaxis should be considered, especially if there is a high risk of infection, such as with cat bites, with puncture wounds, with wounds to the hand, and in persons who are immunosuppressed 5
  • Antibiotic choice: Amoxicillin/clavulanate is the first-line prophylactic antibiotic 6, 5
  • Rabies prophylaxis: The need for rabies prophylaxis should be addressed with any animal bite because even domestic animals are often unvaccinated 6, 5, 7
  • Postexposure rabies prophylaxis: Postexposure rabies prophylaxis consists of immune globulin at presentation and vaccination on days 0, 3, 7, and 14 5
  • Tetanus immunization: Tetanus immunization status should be routinely addressed in bite wound management 6, 7
  • Patient education: Counseling patients and families about animal safety may help decrease animal bites 5

Special Considerations

  • Cat bite wounds on the hand: Have the greatest risk of infection 6
  • Pasteurella multocida: Isolated in over half of all cat bite wounds and can cause serious infection with severe complications 6, 8
  • Complications: Such as tendosynovitis, arthritis, abscesses, and septicaemia can occur in cat bite wounds 8

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.