Treatment Duration for Dog Bite with Augmentin
For prophylactic treatment of dog bites, prescribe amoxicillin-clavulanate (Augmentin) 875/125 mg twice daily for 3-5 days. 1
Prophylactic Treatment (No Active Infection)
The Infectious Diseases Society of America recommends 3-5 days of preemptive antimicrobial therapy for patients meeting high-risk criteria 1:
- Immunocompromised status 1
- Asplenia 1
- Advanced liver disease 1
- Edema of the affected area 1
- Moderate to severe injuries 1
- Injuries that may have penetrated periosteum or joint capsule 1
Critical timing consideration: Prophylactic antibiotics should only be prescribed if the patient presents within 24 hours of the bite 2. If presenting ≥24 hours after the bite without signs of infection, antibiotics should NOT be prescribed, as prophylactic therapy is only beneficial when given early 2.
Treatment of Established Infection
If infection has already developed, the treatment duration changes significantly:
- Uncomplicated infections: 7-10 days total therapy 2
- Septic arthritis: 4 weeks of antibiotic therapy 1
- Osteomyelitis: 6 weeks of antibiotic therapy 1
The standard dosing remains amoxicillin-clavulanate 875/125 mg twice daily 1, 3.
Dosing Specifics
The FDA-approved dosing for more severe infections is one 875 mg/125 mg tablet every 12 hours 3. This twice-daily regimen is associated with significantly less diarrhea compared to three-times-daily dosing 3.
Common Pitfalls to Avoid
Do not prescribe antibiotics "just in case" for late presentations (≥24 hours) without infection, as this violates guideline recommendations and promotes antimicrobial resistance 2. The infection rate for dog bites is only 5-25%, making routine prophylaxis at late presentation inappropriate 2.
Do not use inadequate antibiotic coverage. First-generation cephalosporins, macrolides, or penicillinase-resistant penicillins should not be used alone, as they have poor activity against Pasteurella multocida, which is present in 50% of dog bites 2.
Follow-Up Requirements
All patients should be seen within 48-72 hours to assess for signs of infection and evaluate wound healing progress 1. If infection progresses despite appropriate antimicrobial therapy, hospitalization should be considered 1.