From the Guidelines
For a cat scratch, immediately clean the wound with mild soap and running tap water for at least 5 minutes to remove bacteria, as recommended by the 2024 American Heart Association and American Red Cross guidelines for first aid 1.
Wound Care Recommendations
- Clean the wound thoroughly with mild soap and running tap water to remove debris and bacteria.
- Avoid using antiseptic agents such as povidone-iodine for wound irrigation, as they may not be necessary and can potentially harm the wound tissue 1.
- Cover the wound with an occlusive dressing to promote wound healing, but remove the dressing and inspect the wound if signs of infection develop, such as redness, swelling, foul-smelling drainage, increased pain, or fever 1.
Infection Prevention and Treatment
- Apply an over-the-counter antibiotic ointment like Neosporin or Polysporin 2-3 times daily for 3-5 days to help prevent infection.
- Monitor the wound for signs of infection, such as increasing redness, swelling, warmth, pus, or red streaks extending from the wound.
- Seek medical attention if you develop fever, severe pain, significant swelling, or if the wound appears infected, especially if you have a weakened immune system.
Cat Scratch Disease Treatment
- If cat scratch disease is suspected, azithromycin may be recommended, with a dosing protocol of 500 mg on day 1 followed by 250 mg for 4 additional days for patients over 45 kg, and 10 mg/kg on day 1 and 5 mg/kg for 4 more days for patients under 45 kg 1.
From the Research
Wound Care for Cat Scratch
- The primary goal of wound care for a cat scratch is to prevent infection and promote healing.
- According to 2, 3, 4, 5, 6, cat-scratch disease is usually a self-limited disease, but antibiotic therapy may be considered for patients with severe disease.
Recommended Treatment
- The majority of cases of cat-scratch disease do not require anti-infective therapy for resolution of infection 2.
- However, if an antibiotic is chosen, azithromycin has been shown to speed recovery 3.
- Other effective antibiotics for cat-scratch disease include rifampin, ciprofloxacin, gentamicin, and trimethoprim-sulfamethoxazole 2, 4, 5, 6.
Wound Care
- Clean the wound with soap and water to prevent infection.
- Apply an antibiotic ointment to the wound to help prevent infection.
- Cover the wound with a bandage to protect it from further irritation.
Special Considerations
- Immunocompromised individuals with B. henselae infection may develop more severe disease, such as bacillary angiomatosis, bacillary peliosis, and relapsing bacteremia with fever syndrome 2.
- In these cases, antibiotic therapy is often necessary to prevent serious complications.