What antibiotics are recommended for treatment of a dog bite?

From the Guidelines

For a dog bite, the first-line antibiotic treatment should be amoxicillin-clavulanate (Augmentin) at 875/125 mg twice daily for adults or 45 mg/kg/day divided into two doses for children, for 5-7 days, as recommended by the Infectious Diseases Society of America 1. This recommendation is based on the guidelines for the diagnosis and management of skin and soft tissue infections, which suggest that amoxicillin-clavulanate is effective against a wide range of bacteria that can be introduced into the wound through a dog bite, including Pasteurella, Streptococcus, Staphylococcus, and anaerobes. Some key points to consider when treating a dog bite include:

• Prompt attention is necessary to prevent infection, and treatment should begin as soon as possible after the bite occurs.
• Proper wound care is essential, including thoroughly cleaning the wound with soap and water, applying antiseptic, and seeking medical attention for proper assessment, especially for deep wounds, facial bites, or if you have underlying conditions like diabetes or immunosuppression.
• Alternative antibiotic options may be necessary for individuals who are allergic to penicillin, such as a combination of clindamycin (300 mg three times daily) plus either trimethoprim-sulfamethoxazole or a fluoroquinolone.
• A tetanus booster may also be necessary if your vaccination isn't current. It's also important to note that the bacteriology of dog bite wounds can be complex, and empirical therapy may not always cover all possible pathogens, highlighting the importance of proper wound care and medical assessment 1.

From the Research

Antibiotics for Dog Bites

• The use of antibiotics in dog bite wounds is a common practice to prevent infection.
• A study published in the Australian veterinary journal 2 found that amoxicillin-clavulanic acid is an effective empirical antimicrobial choice for moderate dog bite wounds.
• The study also found that the addition of enrofloxacin did not significantly reduce the complication rate due to infection, and that over 90% of gram-negative and gram-positive isolates were susceptible to amoxicillin-clavulanic acid.

Commonly Prescribed Antibiotics

• Amoxicillin-clavulanic acid is the most commonly prescribed antibiotic for dog bite wounds, according to a retrospective study published in the Journal of veterinary internal medicine 3.
• The study found that amoxicillin-clavulanic acid was prescribed in 73.4% of dog bite cases, followed by first-generation cephalosporins.
• However, the study also found that underdosing occurred in 13.4% of cases where amoxicillin-clavulanic acid was prescribed.

Safety and Efficacy of Antibiotics

• A safety review published in Expert opinion on drug safety 4 found that amoxicillin and amoxicillin-clavulanic acid are generally safe and effective, but that the clavulanate component can cause adverse reactions.
• A study published in Pharmacy (Basel, Switzerland) 5 found that amoxicillin-clavulanate may be a useful alternative therapy for the treatment of ceftriaxone non-susceptible urinary tract infections.
• Another study published in The Pediatric infectious disease journal 6 found that amoxicillin-clavulanate had clinical efficacy comparable to penicillin V in the treatment of group A streptococcal tonsillopharyngitis, but was less effective in eradicating clarithromycin-resistant isolates.