What is the treatment for a rabbit bite?

Treatment of Rabbit Bites

The treatment of rabbit bites should include immediate and thorough wound cleansing with soap and water, assessment for potential rabies exposure, tetanus prophylaxis as indicated, and appropriate antibiotic therapy for high-risk wounds. 1

Initial Wound Management

• Immediate and thorough washing of all bite wounds and scratches with soap and water is crucial for preventing infection and reducing the risk of rabies transmission 1
• For many bite wounds, gentle irrigation with water or a dilute povidone-iodine solution markedly decreases the risk of bacterial infection 1
• Care should be taken not to damage skin or tissues during cleansing 1
• Thorough wound cleansing alone without other post-exposure prophylaxis has been shown to markedly reduce the likelihood of rabies in animal studies 1

Wound Closure Considerations

• The decision to suture large wounds should take into account cosmetic factors and the potential for bacterial infections 1
• Suturing should be avoided when possible to reduce infection risk 1
• Primary wound closure should be individualized based on:
  • Size and location of the wound
  • Time interval since the bite
  • Risk of infection 1

Antibiotic Therapy

• Antibiotic prophylaxis should be considered for:
  • Puncture wounds
  • Hand wounds
  • "Dirty" wounds of any type
  • Immunocompromised patients 2, 3
• Amoxicillin/clavulanate is the first-line prophylactic antibiotic for animal bites 3
• Antibiotic therapy should cover both aerobic and anaerobic organisms that may be present in the rabbit's oral flora and the patient's skin 4, 5

Tetanus Prophylaxis

• Tetanus prophylaxis should be administered as indicated based on the patient's immunization status 1
• Review of the patient's tetanus status is mandatory for all animal bites 2

Rabies Considerations

• While rabbits are not common rabies vectors, the risk should be assessed based on:
  • Whether the rabbit was wild or domestic
  • The circumstances of the bite (provoked vs. unprovoked)
  • The prevalence of rabies in the local area 1
• If rabies exposure is suspected:
  • For previously unvaccinated persons: administer both rabies immune globulin (RIG) and vaccine 1
  • The recommended dose of human RIG is 20 IU/kg body weight 1
  • If anatomically feasible, infiltrate the full dose of RIG in and around the wound area 1
  • A regimen of five 1-mL doses of rabies vaccine should be administered intramuscularly on days 0,3,7,14, and 28 1

Follow-up Care

• Monitor for signs of infection including increasing pain, redness, swelling, warmth, or purulent drainage 4, 5
• Be alert for potential complications such as lymphangitis, local abscess, septic arthritis, tenosynovitis, and osteomyelitis 4, 5
• In most states, physicians are required by law to report animal bites to appropriate authorities 3

Special Considerations

• Wounds to the hands, face, or joints require special attention due to higher risk of complications 3
• Immunocompromised patients may require more aggressive treatment and monitoring 5