Should I administer moxifloxacin (moxifloxacin) to a patient with rat poisoning and a cut injury to the left wrist, who has normal lab reports and stable vitals?

Antibiotic Prophylaxis for Traumatic Wound in Rat Poisoning Patient

Do not administer moxifloxacin 1.2g IV to this patient. The patient has stable vitals, normal lab reports, and no evidence of active coagulopathy from the rat poisoning, making routine antibiotic prophylaxis for a simple cut injury unnecessary and potentially harmful.

Clinical Assessment Priority

First, determine the type and severity of rat poisoning:

• Anticoagulant rodenticides (most common) cause coagulopathy through vitamin K-dependent clotting factor depletion, which may not manifest immediately in laboratory values 1, 2
• Check coagulation parameters specifically: PT/INR, aPTT, and vitamin K-dependent factors (II, VII, IX, X) 2
• Normal initial labs do not exclude significant rodenticide exposure, as coagulopathy can develop over days 2

Wound Management Without Antibiotics

For a simple cut injury to the wrist with stable vitals:

• Clean the wound thoroughly with copious irrigation 3
• Assess for depth, contamination, and neurovascular compromise
• Primary closure if appropriate, or leave open if contaminated
• Tetanus prophylaxis if indicated
• Prophylactic antibiotics are NOT routinely indicated for clean or minimally contaminated wounds in stable patients

Why Moxifloxacin is Inappropriate Here

Moxifloxacin 1.2g IV represents excessive and unjustified antibiotic use:

• No evidence of infection, sepsis, or immunocompromise described
• Stable vitals argue against systemic infection
• Moxifloxacin is a broad-spectrum fluoroquinolone reserved for serious infections 4
• The dose (1.2g) is three times the standard dose (400mg), suggesting confusion about appropriate dosing 4

Actual Treatment Priorities for Rat Poisoning

Focus on the poisoning itself, not unnecessary antibiotics:

• Vitamin K1 is the definitive antidote for anticoagulant rodenticide poisoning 1, 2
• Administer vitamin K1 infusion if coagulopathy develops (may require 550mg total over weeks for long-acting rodenticides) 2
• Monitor coagulation parameters daily for at least 48-72 hours, as effects can be delayed 1, 2
• Fresh frozen plasma may be needed if active bleeding develops 2
• Contact poison control center immediately for specific guidance 3, 5

Critical Pitfall to Avoid

The major error here is treating the wrong problem:

• The wound is a minor issue requiring basic wound care
• The rat poisoning is the potentially life-threatening condition requiring monitoring and possible vitamin K1 therapy 1, 2
• Administering unnecessary antibiotics contributes to antimicrobial resistance and exposes the patient to adverse effects without benefit
• "Normal labs" at presentation do not exclude evolving coagulopathy from rodenticide exposure 2

Appropriate Antibiotic Indications (None Present Here)

Antibiotics would only be indicated if:

• Signs of established wound infection develop (erythema, purulence, fever)
• Deep contaminated wound with devitalized tissue
• Immunocompromised state
• High-risk anatomic location with joint or tendon involvement

In this stable patient with a simple cut, wound care and monitoring for delayed coagulopathy from the poisoning are the appropriate interventions, not moxifloxacin.