From the Guidelines
For a pet rabbit bite, the recommended antibiotic prophylaxis is amoxicillin-clavulanate (Augmentin) 875/125 mg orally twice daily for 3-5 days. This is the first-line treatment because rabbit bites can introduce Pasteurella multocida bacteria, which is commonly found in rabbit oral flora, along with other aerobic and anaerobic organisms 1. For patients with penicillin allergies, alternatives include doxycycline 100 mg twice daily, trimethoprim-sulfamethoxazole (TMP-SMX) 1-2 tablets twice daily, or fluoroquinolones like ciprofloxacin 500 mg twice daily for the same duration. Some key points to consider when treating a pet rabbit bite include:
- Thorough wound cleaning with soap and water, irrigation with sterile saline, and debridement of any devitalized tissue 1
- Tetanus prophylaxis should be administered if the patient's immunization status is not up to date 1
- The risk of infection is higher in rabbit bites compared to many other animal bites, with infections potentially developing within 24 hours 1
- The bacteriology of these wounds can differentiate the number of isolates per wound and whether additional coverage for anaerobes is required 1 It's also important to note that the bacteriology of rabbit bites can include a variety of organisms, such as Pasteurella multocida, streptococci, and anaerobes, and that empirical therapy might miss pathogens if not properly managed 1.
From the Research
Recommended Antibiotic Prophylaxis for Pet Rabbit Bites
- The recommended antibiotic prophylaxis for pet rabbit bites is primarily aimed at treating infections caused by Pasteurella multocida, a common bacterium found in animal bites 2, 3, 4, 5.
- Penicillin or amoxicillin is considered the agent of choice for therapy, but alternative oral agents such as ampicillin, amoxicillin/clavulanate, cefprozil, cefuroxime, trimethoprim/sulfamethoxazole, and ciprofloxacin may be appropriate for therapy of P. multocida infections 2.
- Tetracyclines and beta-lactam antibiotics are usually recommended for the treatment of pasteurellosis following bite wounds, but other oral antimicrobial agents such as clarithromycin, azithromycin, pristinamycin, and ciprofloxacin may be proposed as therapeutic alternatives 3.
- The antimicrobial susceptibility pattern of P. multocida isolates suggests that the majority of strains are susceptible to most widely used commercial antimicrobial agents, but resistance to sulphonamides, tetracyclines, first-generation quinolones, and aminoglycosides is remarkable 4.
- Certain cephalosporins, erythromycin, and oxacillin have been shown to lack in vitro efficacy against P. multocida, and should not be used for empiric therapy of animal bite wounds 5.
Alternative Antibiotic Options
- Trimethoprim-sulfamethoxazole and ciprofloxacin may be proposed as therapeutic alternatives in case of pasteurellosis following animal bites 3.
- The classical penicillin, newer macrolide (tulathromycin), third-generation fluoroquinolone (enrofloxacin), and fourth-generation cephalosporin (cefquinome) have shown satisfactory antimicrobial activity against P. multocida 4.
- Agents that are consistently active against P. multocida include penicillin, ampicillin, amoxicillin-clavulanic acid, tetracycline, minocycline, chloramphenicol, trimethoprim-sulfamethoxazole, and cefuroxime 5.