What is the treatment for a canine bite?

From the Guidelines

If you've been bitten by a dog, immediately clean the wound thoroughly with soap and water for at least 5 minutes to reduce infection risk and seek medical attention promptly if the wound is deep or if you notice signs of infection. Applying gentle pressure with a clean cloth to stop bleeding is also crucial. For minor bites, apply an antibiotic ointment like Neosporin and cover with a sterile bandage.

Key Considerations

• The wound should be cleaned thoroughly to reduce the risk of infection, which can be caused by various bacteria present in a dog's mouth, including Pasteurella multocida, streptococci, and anaerobes 1.
• For deeper wounds or if there are signs of infection such as increasing redness, swelling, warmth, pus, or fever, medical attention is necessary as stitches, antibiotics, or a tetanus shot may be required 1.
• Commonly prescribed antibiotics for dog bites include amoxicillin-clavulanate (Augmentin) 875/125 mg twice daily for 5-7 days, as it has excellent activity against Pasteurella multocida and some streptococci, although some gram-negative rods are resistant and it misses MRSA 1.

Treatment Approach

• The choice of antibiotic should be based on the severity of the bite and the potential pathogens involved, with amoxicillin-clavulanate being a recommended option for animal bites due to its broad-spectrum activity 1.
• If there is a history of hypersensitivity to β-lactams, alternative treatments such as a fluoroquinolone (e.g., ciprofloxacin or levofloxacin) plus metronidazole, or moxifloxacin as a single agent, may be considered 1.
• It's essential to watch for signs of infection and seek medical evaluation if the dog's vaccination status is unknown or if the bite is severe, especially on the face, hands, or genitals, to assess rabies risk and provide appropriate care 1.

From the FDA Drug Label

The essential components of rabies post-exposure prophylaxis are wound treatment and, for previously unvaccinated persons, the administration of both human rabies immune globulin (RIG) and vaccine. Thoroughly wash and flush all bite wounds and scratches immediately or as early as possible (for about 15 minutes, if possible) with soap or a cleansing agent and copious amounts of water. Apply an iodine-containing, or similarly viricidal, topical preparation to the wound (3) Administer Tetanus prophylaxis and measures to control bacterial infection, as indicated. Administer post-exposure antirabies vaccination with rabies vaccine in addition to administering Rabies Immune Globulin (RIG)

Treatment for Dog Bite:

• Immediately wash the wound with soap and water for about 15 minutes.
• Apply an iodine-containing topical preparation to the wound.
• Administer Tetanus prophylaxis and measures to control bacterial infection, as indicated.
• Administer post-exposure antirabies vaccination with rabies vaccine in addition to administering Rabies Immune Globulin (RIG) if the person has not been previously vaccinated.
• Consult local and state public health officials if questions arise about the need for rabies prophylaxis 2

From the Research

Dog Bite Treatment Overview

• Dog bites can lead to various complications, including infected wounds, musculoskeletal and neurovascular injuries, and systemic infections 3.
• Treatment of dog bites involves thorough cleansing of the wound with copious irrigation, and abscesses should undergo incision and drainage 3.

Antibiotic Treatment

• Suitable antibiotics for the initial empiric and expectant therapy include amoxicillin-potassium clavulanate, a penicillin with a first generation cephalosporin, or clindamycin and a fluoroquinolone 3.
• The choice of antibiotic may depend on the patient's medical history and the circumstances surrounding the bite 4.

Rabies Prophylaxis

• Local wound management is an essential part of postexposure rabies prophylaxis, and exposed persons should receive a recommended series of a tissue culture or cell culture origin vaccine 5.
• The administration of a rabies immune globulin is generally recommended in conjunction with the first dose of the rabies vaccine 5, 6.
• Rabies pre-exposure immunisation is recommended for those individuals at risk of exposure to the virus, and consists of 3 doses of an approved rabies vaccine administered either intramuscularly or intradermally on days 0,7, and 21 or 28 with periodic booster doses or titre determination depending on the level of risk of potential exposure to the virus 5.

Novel Strategies for Rabies Treatment

• Live-attenuated viruses have recently emerged as a practical and promising approach for immunizing and controlling rabies, and could be used as putative candidates for live-attenuated rabies vaccine 6.
• Additional novel strategies, such as a monoclonal antibody-based approach, nucleic acid-based vaccines, or small interfering RNAs (siRNAs) interfering with virus replication, could further add to the arena of strategies to combat rabies 6.

Abridged Vaccination Schedules

• Abridged schedules with less doses have potential to save costs, increase patient compliance, and thereby improve equitable access to life-saving post-exposure prophylaxis (PEP) for at-risk populations 7.
• The 1-week, 2-site ID PEP schedule was found to be most advantageous, as it was safe, immunogenic, supported by clinical outcome data and involved the least direct costs compared to other schedules 7.