From the Guidelines
For a human bite, immediate cleaning with soap and water, followed by application of an antiseptic and covering with a clean bandage, is crucial, and a healthcare provider may prescribe antibiotics such as amoxicillin-clavulanate 875/125 mg twice daily for 5-7 days to prevent infection, as recommended by the Infectious Diseases Society of America 1.
Key Considerations
- Human bites can introduce a wide range of bacteria into the wound, including Streptococcus, Staphylococcus, and anaerobes, which can lead to serious infections.
- The decision to give prophylactic antibiotics should be based on wound severity and host immune competence, with a focus on high-risk wounds such as those involving the hand, face, or foot, or in patients with immunocompromising conditions.
- Amoxicillin-clavulanate is a recommended antibiotic for human bites due to its broad-spectrum activity against common bite wound pathogens, including Eikenella corrodens, which is resistant to many other antibiotics.
Management Steps
- Clean the wound immediately with soap and water for at least 5 minutes.
- Apply an antiseptic like hydrogen peroxide or povidone-iodine.
- Cover the wound with a clean bandage.
- Seek medical attention promptly, especially if the bite broke the skin.
- Watch for signs of infection, including increasing pain, redness, swelling, warmth, pus, or red streaks extending from the wound.
Antibiotic Therapy
- Amoxicillin-clavulanate 875/125 mg twice daily for 5-7 days is a commonly recommended antibiotic regimen for human bites.
- The choice of antibiotic should be guided by the severity of the wound, the patient's immune status, and the potential for antibiotic resistance.
- In patients with a history of hypersensitivity to β-lactams, alternative antibiotics such as fluoroquinolones (e.g., ciprofloxacin or levofloxacin) plus metronidazole, or moxifloxacin as a single agent, may be considered.
From the Research
Human Bite Wound Care
To manage a human bite, the following steps should be taken:
- Elicit a history of the circumstances surrounding the bite and the patient's medical history 2
- Perform basic bite wound care, including:
- Cleansing of the wound
- Irrigation of the wound 2
- Consider the bacteriology of the bite wound to determine if antibiotics may be indicated 2
- Consider rabies and tetanus prophylaxis 2
- Ensure appropriate follow-up care 2
Antibiotic Treatment and Prophylaxis
Antibiotics may be indicated in certain situations, such as: