Treatment Duration for Human Bite Infection with Cheek Swelling
For a human bite infection causing cheek swelling, Augmentin (amoxicillin/clavulanate) should be administered for 3-5 days if the infection is mild to moderate, with extension to 10-14 days for more severe infections or those involving deeper tissues. 1
Recommended Treatment Approach
Initial Assessment
- Evaluate severity of infection:
- Presence of systemic symptoms (fever, tachycardia)
- Extent of swelling and induration
- Depth of bite wound (superficial vs. deep)
- Proximity to vital structures (facial nerves, salivary ducts)
Antimicrobial Selection
- First-line therapy: Amoxicillin-clavulanate (Augmentin) 1
- Adult dosing: 875/125 mg twice daily orally
- Provides coverage against typical human bite flora:
- Viridans streptococci (present in 80% of wounds)
- Staphylococci
- Eikenella corrodens
- Anaerobes (Fusobacterium, Prevotella, Porphyromonas species)
Duration of Therapy
- Mild to moderate infection: 3-5 days 1
- Severe infection or deeper tissue involvement: 10-14 days 1
- Continue treatment until patient is clinically improved for at least 48 hours
Special Considerations
Factors Warranting Longer Treatment Duration
- Immunocompromised status
- Facial location (cheek wounds have rich blood supply but higher risk of cosmetic complications)
- Evidence of deeper tissue involvement
- Delayed presentation (>24 hours after injury)
- Poor initial response to therapy
Monitoring Response
- Assess clinical improvement within 48-72 hours
- If minimal improvement after 3 days, consider:
- Alternative antibiotics
- Possible incision and drainage if abscess has formed
- Imaging to rule out deeper tissue involvement
Common Pitfalls to Avoid
Inadequate duration: Human bite infections, particularly on the face, require adequate treatment duration to prevent complications and cosmetic issues.
Delayed treatment: Human bite wounds are more serious than many animal bites and should be treated promptly.
Inadequate spectrum: Using antibiotics without coverage for the polymicrobial nature of human bite infections (both aerobic and anaerobic organisms).
Missing deeper infections: Facial bites can appear deceptively benign while infection tracks along tissue planes.
Human bite infections, especially those involving the face, require careful management due to the rich vascularity of facial tissues and cosmetic concerns. The duration of therapy should be tailored to the severity of infection, with shorter courses (3-5 days) appropriate for mild infections showing rapid improvement, and longer courses (10-14 days) necessary for more severe or complicated infections 1.