What is the recommended treatment duration with Augmentin (amoxicillin/clavulanate) for a cat bite?

Treatment Duration for Cat Bite Infections with Augmentin

The recommended treatment duration for cat bites with amoxicillin-clavulanate (Augmentin) is 7-10 days. 1

Microbiology and Infection Risk

• Cat bites have a high infection rate with an average of 5 different bacterial isolates per wound, including Pasteurella multocida (75% of bites), staphylococci and streptococci (40%), and anaerobic bacteria (65%) 1
• Cat bites on the hand carry the highest risk of infection and complications, including septic arthritis, osteomyelitis, tendonitis, and even bacteremia 1, 2
• Symptoms of infection can develop rapidly, sometimes within 3 hours after the bite 3

First-Line Treatment

• Amoxicillin-clavulanate (875/125 mg twice daily) is the recommended first-line oral therapy for cat bite infections 1, 4
• This antibiotic is preferred because it provides:
  • Excellent coverage against P. multocida
  • Good activity against staphylococci and streptococci
  • Effective coverage against anaerobic organisms 1

Treatment Duration Rationale

• The 7-10 day treatment duration is based on clinical practice guidelines from the Infectious Diseases Society of America 4, 1
• This duration allows sufficient time to eradicate the polymicrobial infection while preventing complications 1
• For comparison, other skin infections like erysipeloid are also recommended to be treated with penicillin or amoxicillin for 7-10 days 4

Alternative Options for Penicillin-Allergic Patients

• For patients with penicillin allergies, consider:
  • Doxycycline (100 mg twice daily) for 7-10 days 1, 4
  • Fluoroquinolones (e.g., ciprofloxacin 500-750 mg twice daily) for 7-10 days 1, 4
• Avoid first-generation cephalosporins, penicillinase-resistant penicillins, macrolides, and clindamycin as they have poor activity against P. multocida 1

Important Clinical Considerations

• Wound care including thorough irrigation and debridement is essential in addition to antibiotic therapy 1, 2
• Prompt treatment is critical as longer time intervals between bite and treatment are associated with higher infection rates 5
• For severe infections or those involving joints, tendons, or bones, consider hospital admission and possible surgical intervention 2
• Always assess tetanus immunization status in all bite wound patients 6

Monitoring and Follow-up

• Close follow-up is recommended to ensure resolution of infection 2
• If symptoms worsen despite appropriate antibiotic therapy, consider:
  • Possible abscess formation requiring drainage
  • Deeper infection involving tendons, joints, or bones
  • Resistant organisms requiring alternative antibiotics 2, 3