From the Guidelines
For a patient with a cat bite who is taking Augmentin (amoxicillin-clavulanate) and getting worse, the most appropriate antibiotic switch would be to Moxifloxacin 400 mg daily for 7-10 days, as it provides broad coverage against both aerobes and anaerobes, including Pasteurella multocida, which is commonly found in cat bites 1. This recommendation is based on the most recent and highest quality study available, which suggests that Moxifloxacin is effective against a wide range of pathogens, including those that may be resistant to Augmentin 1.
Key Considerations
- Cat bites often involve polymicrobial infections, including anaerobes and other organisms like Streptococcus, Staphylococcus, and Capnocytophaga species 1.
- Clinical worsening on Augmentin suggests either resistance or inadequate coverage of the causative organisms, highlighting the need for broader antibiotic coverage 1.
- Moxifloxacin is a fluoroquinolone with good activity against P. multocida, as well as anaerobes, making it a suitable choice for treating cat bites that are not responding to Augmentin 1.
Additional Recommendations
- Wound culture and sensitivity testing should be performed to guide targeted therapy, if possible 1.
- The wound should be thoroughly cleaned, irrigated, and potentially surgically debrided if there is evidence of abscess formation or necrotic tissue 1.
- It is essential to monitor the patient's response to the new antibiotic regimen and adjust as necessary to ensure the best possible outcome in terms of morbidity, mortality, and quality of life 1.
From the Research
Patient Treatment with Augmentin
The patient is currently taking Augmentin (amoxicillin/clavulanate) for a cat bite, but their condition is worsening.
- The current medication, Augmentin, is a broad-spectrum antibacterial agent effective against a wide range of bacteria, including those that produce beta-lactamases 2.
- However, the patient's worsening condition may indicate the presence of a resistant bacterial strain or an infection that requires a different antibiotic.
Alternative Anabiotic Options
Considering the patient's condition is not improving with Augmentin, alternative anabiotic options may be necessary.
- There is no direct evidence in the provided studies to recommend a specific alternative anabiotic for a patient with a cat bite who is taking Augmentin and getting worse.
- The studies primarily discuss the efficacy, safety, and usage of amoxicillin and amoxicillin-clavulanic acid in various infections, including respiratory tract infections 2, 3, 4.
- It is essential to consider the type of bacteria causing the infection and the patient's overall health status when selecting an alternative antibiotic.
Important Considerations
When choosing an alternative anabiotic, several factors should be considered.
- The potential for antibiotic resistance and the emergence of resistant bacterial strains 2, 4.
- The safety profile of the alternative antibiotic, including the risk of adverse reactions and interactions with other medications 3.
- The patient's medical history, including any allergies or sensitivities to antibiotics.