From the Guidelines
Augmentin 875/125 mg is sufficient for dog bite prophylaxis in a 10-year-old female weighing 47.9 kg. The recommended dosage for children weighing over 40 kg is the adult dose of 875/125 mg twice daily for 3-5 days, as stated in the guidelines by the Infectious Diseases Society of America 1. This provides appropriate coverage against common pathogens found in dog bites, including Pasteurella, Streptococcus, Staphylococcus, and anaerobes. The amoxicillin component (875 mg) delivers approximately 18 mg/kg per dose for this patient, which falls within the therapeutic range, while the clavulanate extends coverage to beta-lactamase producing organisms.
The medication should be taken with food to minimize gastrointestinal side effects. The wound should also be thoroughly cleaned with soap and water, and tetanus prophylaxis should be administered if the child's immunization status is not up to date. If the bite is severe, involves the hand or face, or if there are signs of infection, a longer course of antibiotics may be necessary, and the patient should be reevaluated within 48 hours. It's worth noting that the decision to give “prophylactic” antibiotics should be based on wound severity and host immune competence, as suggested by the guidelines 1.
Some key points to consider in the management of dog bites include:
- The bacteriology of these wounds can be complex and may include aerobic and anaerobic bacteria
- The risk of infection is higher in certain types of wounds, such as puncture wounds or those involving the face, hand, or foot
- The use of prophylactic antibiotics should be limited to high-risk wounds, as suggested by a meta-analysis of 8 randomized trials of dog bite wounds 1
- Amoxicillin-clavulanate is a recommended antibiotic for the treatment of dog bites, due to its broad spectrum of activity against common pathogens.
From the FDA Drug Label
Patients Weighing 40 kg or More: Pediatric patients weighing 40 kg or more should be dosed according to adult recommendations The patient weighs 47.9 kg, which is more than 40 kg.
- Dosing: According to the label, the patient should be dosed according to adult recommendations.
- Augmentin 875/125 mg: Since the patient is being treated as an adult, the dose of 875/125 mg every 12 hours is within the recommended dosing regimen for more severe infections. The dose of Augmentin 875/125 mg is sufficient for a 10-year-old female weighing 47.9 kg for dog bite prophylaxis, assuming the infection is more severe 2.
From the Research
Dog Bite Prophylaxis
- The patient is a 10-year-old female who weighs 47.9 kg and has suffered a dog bite.
- The question is whether Augmentin 875/125 mg is sufficient for prophylaxis.
Antibiotic Prophylaxis Guidelines
- According to 3, initiation of prophylactic antibiotics is indicated for moderate or severe bite wounds, puncture wounds, facial bites, bites to the hands or feet, or genital area bites, or wounds sustained by victims who are immunocompromised or asplenic.
- The first-line choice of antibiotic is amoxicillin-clavulanate, which is the same as Augmentin.
- However, the dosage and duration of antibiotic prophylaxis are not specified in the provided studies.
Infection Rates and Antibiotic Prophylaxis
- A study by 4 found that there was no difference in infection rates between children who received antibiotic prophylaxis and those who did not.
- Another study by 5 found that puncture wounds and wound closure were independent predictors of infection, and that these types of wounds may benefit from prophylactic antibiotics.
- The overall infection rate for pediatric dog bite injuries was found to be around 5% in studies by 4 and 5.
Augmentin Dosage
- The dosage of Augmentin 875/125 mg is a common adult dosage, but the appropriate dosage for a 10-year-old child is not specified in the provided studies.
- It is essential to consult a healthcare professional to determine the appropriate dosage and duration of antibiotic prophylaxis for the patient.