From the Guidelines
For an infected spider bite, seek medical attention promptly, as the most recent guidelines from 2024 recommend emergency services be called if symptoms develop throughout the body, and medical care should be sought if pain extends beyond the site of the bite, becomes severe, or if an open wound develops 1.
Key Considerations
- Clean the bite with soap and water, then apply an antibiotic ointment like Neosporin or bacitracin and cover with a clean bandage, changing it daily.
- Take over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil) as needed for pain.
- A healthcare provider may prescribe oral antibiotics, but the choice should be guided by the most recent and highest quality evidence available.
Antibiotic Treatment
- According to the most recent guidelines, the choice of antibiotic should cover common pathogens such as streptococci, S. aureus, and anaerobic organisms, but the specific recommendation for spider bites is not directly addressed in the provided evidence.
- However, for animal bites, which may serve as a proxy, amoxicillin-clavulanate is often recommended, but the provided evidence does not directly address spider bites 1.
- Given the lack of direct evidence for spider bites, it is crucial to follow the general principles of wound care and seek medical attention for severe or worsening symptoms, as recommended by the 2024 guidelines 1.
Monitoring and Follow-Up
- Watch for worsening symptoms like increasing redness, warmth, swelling, pus, fever, or red streaks extending from the bite, which indicate the infection is spreading.
- Prompt treatment prevents complications like cellulitis or systemic infection.
Conclusion is not allowed, so the answer ends here.
From the Research
Treatment for Infected Spider Bites
- The treatment for infected spider bites often involves aggressive surgical debridement and the use of intravenous antibiotics, particularly in cases where the infection is caused by methicillin-resistant Staphylococcus aureus (MRSA) 2.
- In some cases, the use of antibiotics with activity against MRSA, such as trimethoprim-sulfamethoxazole, may be necessary 2.
- Surgical intervention may be required to manage long-term peripheral neuropathy refractory to conservative therapy 3.
- The management of spider bites should include minimizing inflammation and tissue necrosis, preventing bacterial superinfection, and controlling pain levels 3.
- In cases of osteomyelitis caused by brown recluse spider bites, operative debridement and wound closure may be necessary 4.
- Treatment regimens for brown recluse spider bite envenomation should include the basics of wound care, as well as systemic antibiotics, topical antimicrobials, dapsone, and surgical debridement as indicated 4.
Specific Spider Bites
- Brown recluse spider bites can cause significant trauma via their tissue toxic venom, and treatment is varied and dependent upon presentation and course of injury 3, 4.
- Funnel web spider bites are a medical emergency and require the application of a pressure immobilisation bandage and transfer to a hospital with available antivenom and resuscitation facilities 5.
- Philodromus sp. spider bites can cause cytotoxic envenomation, and management should be as recommended for other cytotoxic spider bites 6.