Gecko Bite Management: No Antibiotics Needed
For a superficial common house gecko bite in a healthy adult, antibiotics are completely unnecessary, and offering a simple emollient cream or petroleum jelly as a "wound care" product is appropriate if the patient insists on something.
Why Antibiotics Are Not Indicated
The available evidence addresses mammalian bites (dogs, cats, humans) which carry significantly higher infection risks than reptile bites. Even in these higher-risk scenarios:
- Universal antibiotic prophylaxis is not recommended for bite wounds 1
- Antibiotics should not be given if the patient presents 24 hours or more after the bite with no clinical signs of infection 1
- Low-risk wounds (superficial, not involving hands/feet/joints, epidermis only) have infection rates of only 1.6% even without antibiotics 2
Gecko Bites Are Even Lower Risk
House gecko bites are substantially lower risk than the mammalian bites discussed in guidelines because:
- Geckos lack the polymicrobial oral flora (Pasteurella, anaerobes, Staphylococcus) that make dog, cat, and human bites concerning 1
- Superficial gecko bites don't penetrate deeply and cause minimal tissue trauma
- The infection rates for properly cleaned low-risk mammalian bites are already negligible 2
Appropriate Management
Wound care only:
- Cleanse with sterile normal saline or warm water (no need for iodine or antibiotic solutions) 1
- Remove any superficial debris 1
- Keep the area clean and dry
If the patient insists on "something":
- Offer a bland emollient cream, petroleum jelly, or plain wound ointment without antibiotics
- This provides psychological reassurance without contributing to antibiotic resistance
- Frame it as "wound care" rather than infection prevention
Red Flags Requiring Medical Attention
Advise the patient to return if they develop:
- Erythema extending >5 cm from the wound 1
- Temperature >38.5°C or heart rate >110 bpm 1
- Purulent drainage, increasing pain, or swelling 1
- Any signs of infection within 24-48 hours 1
Tetanus Consideration
Ensure tetanus prophylaxis is current (0.5 mL intramuscularly if outdated or unknown status) 1
Common Pitfall to Avoid
Do not prescribe actual antibiotics "just in case" or because the patient requests them. This contributes to antimicrobial resistance without clinical benefit 1. The evidence clearly shows that even for higher-risk mammalian bites, prophylactic antibiotics provide no benefit for low-risk superficial wounds 2.