What patient education and prophylactic Augmentin (amoxicillin/clavulanate) treatment should be provided for a dog bite?

Patient Education for Dog Bite with Prophylactic Augmentin

Take Augmentin 875/125 mg twice daily with food for the full prescribed course, typically 3-5 days for prophylaxis, as this is the first-line antibiotic recommended by the Infectious Diseases Society of America for dog bite wounds. 1

Medication Instructions

• Take each dose with a meal or snack to reduce gastrointestinal upset, which is the most common side effect 2
• Complete the entire course even if you feel better early—stopping early decreases effectiveness and increases antibiotic resistance 2
• Do not skip doses as this compromises treatment efficacy 2
• Augmentin covers the polymicrobial bacteria in dog bites, including Pasteurella species (found in 50% of dog bites), staphylococci, streptococci, and anaerobes 1, 3

Wound Care at Home

• Keep the wound clean with gentle washing using soap and water 4, 5
• Watch for signs of infection including increasing redness, warmth, swelling, pus drainage, red streaks extending from the wound, or fever 4
• Do not apply topical antibiotics like mupirocin—systemic antibiotics are what matters for dog bites 1
• The initial copious irrigation performed in the clinic is the most important infection prevention measure 5, 6

Warning Signs Requiring Immediate Medical Attention

• Severe or persistent diarrhea lasting more than 2-3 days, especially if bloody or watery with fever—this can occur up to 2 months after taking antibiotics 2
• Signs of deep infection: disproportionate pain near bones or joints suggesting periosteal penetration, which could indicate septic arthritis or osteomyelitis 7, 3
• Allergic reaction symptoms: rash, hives, difficulty breathing, or swelling (Augmentin contains penicillin) 2
• Systemic symptoms: fever, chills, or feeling generally unwell 3

Tetanus and Rabies Considerations

• Tetanus booster was administered (or confirmed current) if your last vaccination was more than 10 years ago 1, 4
• Rabies risk assessment has been completed based on whether the dog can be observed for 10 days—healthy dogs, cats, and ferrets should be confined and observed daily during this period 7
• If the dog was stray, unwanted, or cannot be located, rabies prophylaxis may be necessary and consists of immune globulin plus vaccination on days 0,3,7, and 14 4
• Contact your local health department immediately if the dog develops any signs of illness during the observation period 7

Special Precautions for Hand Wounds

• Hand bites are often more serious than wounds on fleshy body parts due to proximity to tendons, joints, and bones 3
• Watch especially carefully for pain, stiffness, or swelling in the hand 3
• These wounds have higher risk for complications like tendinitis, septic arthritis, and osteomyelitis requiring 4-6 weeks of antibiotics 7, 3

Prevention Education

• Avoid provoking dogs while they are eating, sleeping, or caring for puppies 8
• Teach children not to approach unfamiliar dogs or disturb dogs that appear frightened or aggressive 8
• Never leave young children unsupervised with any dog, even family pets 4, 8
• Almost half of dog bites involve animals owned by the victim's family or neighbors 8

Common Pitfalls to Avoid

• Do not stop antibiotics early just because the wound looks better—dog bite infections can develop into deep tissue complications 2
• Do not use over-the-counter antibiotics like first-generation cephalosporins (cephalexin) or macrolides if you run out of Augmentin, as these have poor activity against Pasteurella commonly found in dog bites 1, 3
• Do not ignore diarrhea—contact your physician if it becomes severe, as Clostridioides difficile infection can occur 2