From the Guidelines
Neomycin ointment can be applied to a dog bite, but it is not the recommended first-line treatment. For a dog bite, the wound should first be thoroughly cleaned with soap and water for at least 5 minutes, then rinsed well. After cleaning, apply an antiseptic like povidone-iodine or chlorhexidine. Neomycin ointment may be used afterward to help prevent infection, but be aware that some people develop allergic reactions to neomycin with repeated use. Apply a thin layer to the wound 2-3 times daily after cleaning. Cover with a sterile bandage. However, dog bites often require medical attention, especially if the bite is deep, bleeding heavily, shows signs of infection (redness, swelling, warmth, pus), or was from an unknown or unvaccinated dog. Medical professionals may prescribe oral antibiotics like amoxicillin-clavulanate, which are more effective for preventing the polymicrobial infections common in animal bites, as recommended by the Infectious Diseases Society of America 1. They will also assess the need for tetanus or rabies prophylaxis based on your vaccination history and the circumstances of the bite. Some key points to consider when treating dog bites include:
- Cleaning and rinsing the wound thoroughly
- Applying an antiseptic to reduce the risk of infection
- Using neomycin ointment with caution due to the risk of allergic reactions
- Seeking medical attention for deep or severe bites, or if signs of infection are present
- Considering oral antibiotics like amoxicillin-clavulanate for high-risk bites, as recommended by the Infectious Diseases Society of America 1. It's also important to note that the bacteriology of dog bites can be complex, involving multiple aerobic and anaerobic organisms, and that empirical therapy may not always cover all possible pathogens 1.
From the Research
Dog Bite Wounds and Neomycin Ointment
- Dog bite injuries can be managed in an outpatient setting, and wounds should be washed out 2
- However, the use of neomycin ointment on dog bite wounds is not recommended due to the risk of allergic contact dermatitis 3, 4
- Neomycin is a common cause of allergic contact dermatitis, and its use should be avoided in postoperative wound care 3, 4, 5
- Alternative topical antimicrobials that do not contain neomycin can be recommended for open wounds 3
- White petrolatum is an efficacious and cost-effective alternative for closed wounds 3
Risks Associated with Neomycin Ointment
- Allergic contact dermatitis is a significant risk associated with the use of neomycin ointment 3, 4, 5
- The frequency of allergic contact dermatitis to neomycin sulfate is 5.3% in patients who use this antibiotic 4
- Neomycin-containing antibiotics should be avoided in postoperative wound care due to the frequency of allergic contact dermatitis 4
- Bacitracin is also a common culprit of allergic contact dermatitis, although at a lower rate than neomycin 3, 5