What is the role of Augmentin (amoxicillin-clavulanate) in treating dog bites?

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From the Guidelines

Augmentin (amoxicillin-clavulanate) is recommended for dog bites, particularly for high-risk wounds, with a usual adult dose of 875 mg/125 mg twice daily for 5-7 days. The decision to give prophylactic antibiotics should be based on wound severity and host immune competence 1. A meta-analysis of 8 randomized trials of dog bite wounds found that antibiotics reduced the risk of infection, but suggested limiting this to “high risk” wounds 1. Amoxicillin-clavulanate is effective because it covers common bacteria found in dog mouths, including Pasteurella, Streptococcus, Staphylococcus, and anaerobes. The clavulanic acid component helps overcome bacterial resistance.

In addition to antibiotics:

  • Clean the wound thoroughly with soap and water.
  • Apply an antibiotic ointment and cover with a sterile bandage.
  • Seek medical attention for deep wounds or signs of infection.
  • Ensure your tetanus vaccination is up to date. Augmentin helps prevent infection, but it's not a substitute for proper wound care and medical evaluation, especially for severe bites or in high-risk individuals (e.g., immunocompromised patients) 1. The most recent guidelines suggest limiting prophylactic antibiotics to high-risk wounds, such as those involving the face, hand, or foot, or in patients with immunocompromising disorders 1.

The choice of antibiotic should be based on the severity of the wound and the patient's medical history, with amoxicillin-clavulanate being a suitable option for many cases 1. However, it's essential to note that some gram-negative rods may be resistant to amoxicillin-clavulanate, and it may not be effective against MRSA 1. Therefore, the use of Augmentin should be guided by the most recent evidence and clinical judgment, taking into account the individual patient's risk factors and the severity of the wound.

From the FDA Drug Label

Amoxicillin/clavulanic acid has been shown to be active against most isolates of the following bacteria, both in vitro and in clinical infections as described in the INDICATIONS AND USAGE section Gram-positive bacteria Staphylococcus aureus Gram-negative bacteria Enterobacter species Escherichia coli Haemophilus influenzae Klebsiella species Moraxella catarrhalis 1.4 Skin and Skin Structure Infections – caused by beta-lactamase–producing isolates of Staphylococcus aureus, Escherichia coli, and Klebsiella species.

The role of Augmentin (amoxicillin-clavulanate) in treating dog bites is in the treatment of skin and skin structure infections caused by beta-lactamase–producing isolates of Staphylococcus aureus, Escherichia coli, and Klebsiella species, which are common bacteria that can be found in dog bites 2 2.

From the Research

Role of Augmentin in Treating Dog Bites

  • Augmentin, also known as amoxicillin-clavulanate, is the first-line prophylactic antibiotic for treating dog bites, especially in cases where there is a high risk of infection 3, 4, 5, 6.
  • The use of amoxicillin-clavulanate is recommended due to its broad-spectrum coverage of pathogenic flora, which can help prevent infection in dog bite wounds 5, 6.
  • Prophylactic antibiotics, including amoxicillin-clavulanate, have been shown to reduce the incidence of infection in patients with dog bite wounds, with a summary relative risk of 0.56 (95% confidence interval, 0.38 to 0.82) 7.
  • The decision to use antibiotics should be based on the severity of the bite wound, the location of the wound, and the patient's individual risk factors, such as immunosuppression or aspasia 3, 4.

Indications for Antibiotic Prophylaxis

  • Antibiotic prophylaxis is indicated for dog bite wounds that are at high risk of infection, including:
    • Puncture wounds
    • Wounds to the hand or face
    • Wounds in immunosuppressed or asplenic patients
    • Wounds that have undergone primary closure
    • Moderate or severe bite wounds 3, 4, 5.
  • The use of amoxicillin-clavulanate should be considered in all cases where antibiotic prophylaxis is indicated, due to its effectiveness in preventing infection in dog bite wounds 3, 4, 5, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Dog and cat bites.

American family physician, 2014

Research

Child health update. Management of dog bites in children.

Canadian family physician Medecin de famille canadien, 2012

Research

Dog Bite Injuries in the Head and Neck Region: A 20-Year Review.

Craniomaxillofacial trauma & reconstruction, 2019

Research

Management of cat and dog bites.

American family physician, 1995

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.

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