Treatment for Superficial Cat Scratch
The recommended treatment for a superficial cat scratch is to promptly wash the wound with soap and water, followed by application of a topical antibiotic and covering with a clean occlusive dressing to promote healing. 1
Initial Wound Care
- Immediately clean the wound thoroughly with soap and water to reduce the risk of infection 1
- Irrigation with tap water is effective for cleaning the wound and has been shown to be as good as or better than other irrigation solutions in reducing infection rates 1
- Higher volumes of irrigation fluid (100-1000 mL) are more effective than lower volumes 1
Wound Management After Cleaning
- Apply a topical antibiotic to keep the wound moist and prevent drying 1
- Cover the wound with a clean occlusive dressing to promote faster healing 1
- Evidence shows significantly shorter healing time for abrasions treated with occlusive dressings or topical antibiotics versus no dressing or antibiotic 1
Special Considerations for Cat Scratches
- Cat scratches carry a specific risk for Bartonella infection (cat scratch disease) 1
- Prompt washing of cat scratch sites is specifically recommended to reduce the risk of Bartonella infection 1
- Avoid allowing cats to lick open wounds or cuts to prevent potential infections 1
When to Seek Medical Attention
Signs of infection requiring medical attention include:
Immunocompromised individuals (especially HIV-infected persons) should be particularly vigilant about cat scratches due to increased risk of severe Bartonella infections 1
Treatment for Infected Cat Scratches
If cat scratch disease develops (characterized by lymphadenopathy), azithromycin is the recommended treatment 1:
- For patients >45 kg: 500 mg on day 1 followed by 250 mg for 4 additional days
- For patients <45 kg: 10 mg/kg on day 1 and 5 mg/kg for 4 more days
For severe or systemic infections, other effective antibiotics include rifampin, ciprofloxacin, gentamicin, or trimethoprim-sulfamethoxazole 2, 3