Recommended Antibiotic for Cat Bites
Amoxicillin-clavulanate 875/125 mg twice daily is the recommended first-line antibiotic for cat bites due to its excellent coverage against Pasteurella multocida and other common pathogens. 1
Rationale for Antibiotic Selection
Cat bites have a high risk of infection (20-80%) compared to dog bites (3-18%), making appropriate antibiotic therapy crucial 2, 3. The microbiology of cat bite wounds primarily includes:
- Pasteurella multocida (found in approximately 90% of cats' oral cavities) 2
- Staphylococci
- Streptococci
- Anaerobic bacteria 1
Amoxicillin-clavulanate provides comprehensive coverage against these pathogens and is supported by both clinical guidelines and research evidence 1, 2.
Alternative Antibiotics for Penicillin-Allergic Patients
For patients with penicillin allergies, consider:
- Doxycycline (excellent alternative) 1
- Fluoroquinolones (such as levofloxacin) 1, 4
- Second/third-generation cephalosporins (if no history of anaphylaxis to penicillin) 1
Treatment Duration and Monitoring
- Standard duration: 5-7 days for uncomplicated cat bite cellulitis 1
- Assess response within 24-48 hours 1
- Extend treatment if no improvement is seen after 5 days 1
- Monitor for signs of worsening infection (increasing pain, erythema, swelling, purulent drainage) 1
Special Considerations
High-Risk Wounds Requiring Prophylactic Antibiotics
- All cat bites (due to high infection risk) 1, 2
- Bites to the hand (highest infection risk) 1, 3
- Deep puncture wounds 1, 5
- Wounds involving joints, tendons, or bones 1
- Wounds in immunocompromised patients 1
Indications for Hospitalization and IV Antibiotics
- Severe infections with systemic symptoms 1, 6
- Deep infections involving tendons or joints 1
- Hand infections 1
- Immunocompromised patients with moderate to severe infections 1
Additional Management Steps
- Wound Care: Immediate gentle irrigation with water or dilute povidone-iodine solution 1
- Wound Closure: Generally avoid suturing cat bite wounds as it increases infection risk; consider Steri-Strips for wounds seen within 8 hours 1
- Tetanus Prophylaxis: Administer tetanus toxoid (0.5 mL intramuscularly) if vaccination status is outdated or unknown 1
- Rabies Consideration: Consult local health authorities regarding rabies prophylaxis, especially for feral cat bites 1
Common Pitfalls to Avoid
- Delay in treatment: Even small cat bite wounds can lead to serious infections including osteomyelitis and bacteremia 5, 6
- Inadequate wound irrigation: Proper cleansing is as important as antibiotics for infection prevention 1
- Premature wound closure: Suturing cat bites increases infection risk 1
- Underestimating severity: Cat bites can lead to rapid progression of infection, including bacteremia and shock 6