From the Guidelines
Human bites require prompt medical attention, and the most effective treatment is to clean the wound immediately with soap and water, followed by the administration of antibiotics such as amoxicillin-clavulanate 875/125 mg twice daily for 5-7 days, as recommended by the Infectious Diseases Society of America 1. The treatment of human bites involves several key steps to prevent infection and promote healing.
- Cleaning the wound with soap and water for at least 5 minutes is essential to remove debris and bacteria.
- Applying an antiseptic solution like povidone-iodine can help reduce the risk of infection.
- For superficial wounds, continuing to clean the wound, applying antibiotic ointment (such as bacitracin or mupirocin), and covering with a sterile bandage can help promote healing.
- For deeper wounds, punctures, or bites on hands, joints, or face, seeking medical care promptly is crucial as these have higher infection risks. The choice of antibiotic is critical in treating human bites, as the human mouth contains numerous bacteria including Streptococcus, Staphylococcus, and anaerobes that can cause serious infections.
- Amoxicillin-clavulanate is a commonly prescribed antibiotic for human bites, as it provides broad coverage against the mixed oral flora commonly found in human bites 1.
- For penicillin-allergic patients, alternatives include clindamycin plus either ciprofloxacin or trimethoprim-sulfamethoxazole. Tetanus prophylaxis should be updated if needed, and the wound may require debridement, and in some cases, surgical consultation. Close monitoring for signs of infection (increasing redness, swelling, warmth, pus, or fever) is essential, and follow-up within 24-48 hours is recommended to ensure proper healing, as suggested by the American Heart Association 1.
From the Research
Treatment Guidelines for Human Bites
- Human bites are considered dangerous injuries with potentially serious complications, and early treatment, appropriate prophylaxis, and surgical evaluation are key to achieving desired treatment outcomes 2, 3.
- Management of human bites consists of history and examination, wound care, surgical intervention if necessary, assessment of risk of disease transmission, and appropriate antibiotic prophylaxis or treatment 3.
- The best choice for oral or intravenous antibiotic therapy remains the combination of a beta-lactam antibiotic with a beta-lactamase inhibitor, such as amoxicillin/clavulanic acid 3, 4.
- Azithromycin has been shown to be effective against a broad range of anaerobic oral pathogens, including all fusobacteria and beta-lactamase-producing strains of Prevotella spp. 5.
- Eikenella corrodens, a common pathogen in human bites, is susceptible to ciprofloxacin and ceftriaxone, but resistant to erythromycin, gentamicin, and amikacin 6.
Antibiotic Therapy
- Amoxicillin/clavulanate (Augmentin) is a broad-spectrum antibacterial that has been available for clinical use in a wide range of indications, including community-acquired respiratory tract infections 4.
- High-dose amoxicillin/clavulanate formulations have been developed to treat drug-resistant S. pneumoniae, as well as beta-lactamase-producing H. influenzae and M. catarrhalis 4.
- Azithromycin has been shown to be effective against Eikenella corrodens, with all strains susceptible to azithromycin, but resistant to erythromycin, clindamycin, metronidazole, and cefalexin 5.
Surgical Intervention
- Clenched fist injuries, which often require surgical intervention and intravenous antibiotic therapy, are among the most serious human bites 3.
- Surgical evaluation is an important part of the management of human bites, particularly in cases where there is a high risk of infection or complications 2, 3.