From the Guidelines
For a cat bite, the recommended antibiotic is amoxicillin-clavulanate (Augmentin), typically prescribed at 875/125 mg taken twice daily for 5-7 days. This recommendation is based on the most recent and highest quality study available, which prioritizes the treatment of cat bites to prevent infection and promote healing 1. Cat bites often introduce deep puncture wounds with bacteria from the cat's mouth, particularly Pasteurella multocida, which can cause rapid infection. The high infection rate (30-50%) associated with cat bites due to their depth and the bacteria involved necessitates prompt medical attention and professional evaluation.
Some key points to consider in the management of cat bites include:
- Thorough cleaning of the wound with soap and water
- Possible irrigation, debridement, or surgical intervention depending on the severity of the bite
- Alternative antibiotics for patients with penicillin allergy, such as doxycycline, trimethoprim-sulfamethoxazole plus clindamycin, or a fluoroquinolone plus clindamycin
- The importance of not delaying treatment, as infections can develop within 24 hours and may lead to serious complications including cellulitis, abscesses, or even sepsis. The guidelines from the Infectious Diseases Society of America, as outlined in the 2014 update, support the use of amoxicillin-clavulanate as the first-line treatment for animal bites, including cat bites 1.
In terms of specific antibiotic choices, the options include:
- Amoxicillin-clavulanate 875/125 mg bid
- Doxycycline 100 mg bid
- Penicillin plus dicloxacillin 500 mg qid/500 mg qid
- SMX-TMP 160–800 mg bid
- Metronidazole 250–500 mg tid
- Clindamycin 300 mg tid
- Second-generation cephalosporins like cefuroxime 500 mg bid
- Third-generation cephalosporins like ceftriaxone
- Fluoroquinolones like ciprofloxacin 500–750 mg bid, levofloxacin 750 mg daily, or moxifloxacin 400 mg daily. However, amoxicillin-clavulanate remains the preferred choice due to its broad-spectrum activity and effectiveness against Pasteurella multocida 1.
From the Research
Antibiotic Recommendation for Cat Bites
The recommended antibiotic for cat bites is amoxicillin-clavulanate, as stated in multiple studies 2, 3, 4, 5. This antibiotic is effective against Pasteurella multocida, a common bacteria found in cat bite wounds.
Key Points
- Cat bite wounds have a high risk of infection, especially on the hand 2, 5
- Pasteurella multocida is a common bacteria isolated from cat bite wounds 2, 3, 4
- Amoxicillin-clavulanate is the recommended antibiotic for outpatient treatment of cat bites 2, 3, 4, 5
- Antibiotic prophylaxis should be considered for cat bites, especially for puncture wounds, wounds to the hand, and in immunosuppressed individuals 5
Infection Risk and Prevention
- Cat bites have a higher infection rate compared to dog bites, with up to 50% of cat bites becoming infected 3
- Thorough cleansing and debridement of the wound are essential for preventing infection 3, 5
- Healthcare providers should discuss pet safety with patients and their families to prevent animal bites 3, 5