Which emollient cream is appropriate for a healthy adult with a superficial house gecko bite?

Antibiotic Ointment or Cream for Superficial House Gecko Bite

For a superficial house gecko bite in a healthy adult, apply a topical antibiotic ointment or cream (such as bacitracin or mupirocin) and cover with a clean occlusive dressing after thorough irrigation. 1

Immediate Wound Management

Irrigation Protocol

• Irrigate the bite wound thoroughly with copious amounts of warm or room temperature potable water (with or without soap) until no foreign matter remains visible 1
• Large volume irrigation (100-1000 mL) is more effective than smaller volumes for removing debris and reducing bacterial load 2
• Tap water is as effective as sterile saline and superior to antiseptic agents like povidone iodine for initial irrigation 2

Topical Treatment

• After irrigation, apply an antibiotic ointment or cream to the wound 1
• This maintains wound moisture and promotes healing while reducing infection risk 1, 2
• Cover with a clean occlusive dressing, as wounds heal better with less infection when covered compared to leaving them exposed to air 1, 2

Rationale for Antibiotic Coverage

House geckos carry multiple enteric bacterial pathogens in their bodies and fecal matter, including Escherichia coli, Citrobacter freundii, Klebsiella pneumoniae, Salmonella species, and Edwardsiella species 3. While house geckos themselves are non-venomous 4, their bites can introduce these bacteria into wounds, creating infection risk similar to other animal bites 1.

Additional Considerations

Tetanus Prophylaxis

• Evaluate and update tetanus vaccination status as indicated for all animal bites 2, 5

Monitoring for Infection

Seek immediate medical attention if any of the following develop 2:

• Redness, swelling, heat, or increasing pain around the wound
• Red streaks extending from the wound
• Foul-smelling drainage
• Fever or systemic symptoms
• Lymph node enlargement

When Oral Antibiotics Are NOT Needed

Simple, superficial bites in healthy adults that are properly irrigated and dressed do not routinely require oral antibiotics 6. Oral antibiotics are reserved for:

• Extensive or deep wounds
• Wounds showing signs of infection
• Immunocompromised patients
• Bites to high-risk areas (hands, face, joints)

The key distinction is that superficial gecko bites should be treated like other minor animal bites: thorough irrigation, topical antibiotic ointment/cream, and occlusive dressing are sufficient for uncomplicated wounds. 1, 2