What is the treatment for a canine bite (dog bite)?

From the Guidelines

To treat a dog bite, immediately clean the wound with soap and water for at least 5 minutes to remove bacteria, and then apply an antibiotic ointment and cover with a sterile bandage. This is based on the recommendations from the most recent and highest quality study available, which emphasizes the importance of wound cleansing in preventing infection 1.

Key Steps in Treating a Dog Bite

• Clean the wound with soap and water for at least 5 minutes to remove bacteria
• Apply gentle pressure with a clean cloth to stop bleeding
• Apply an antibiotic ointment like Neosporin and cover with a sterile bandage
• Change the dressing daily and monitor for signs of infection
• For deeper or more serious bites, seek medical attention promptly as you may need stitches, antibiotics (commonly prescribed are amoxicillin-clavulanate 875/125 mg twice daily for 5-7 days), or a tetanus booster if yours isn't current (needed every 10 years) 1

Important Considerations

• Dog bites carry a high risk of infection due to the bacteria in a dog's mouth, particularly Pasteurella, Staphylococcus, and Streptococcus species
• Bites on the hands, feet, face, or near joints require professional evaluation
• Verify the dog's rabies vaccination status; if unknown, contact your healthcare provider about rabies prevention measures
• Watch for increasing pain, redness, swelling, warmth, pus, or red streaks extending from the wound, which indicate infection requiring immediate medical care

Additional Recommendations

• Consideration should be given to the need for a booster dose of tetanus vaccine 1
• Decisions regarding the use of antibiotic prophylaxis and primary wound closure should be individualized on the basis of the exposing animal species, size and location of the wound(s), and time interval since the bite 1

From the FDA Drug Label

The essential components of rabies post-exposure prophylaxis are wound treatment and, for previously unvaccinated persons, the administration of both human rabies immune globulin (RIG) and vaccine. Thoroughly wash and flush all bite wounds and scratches immediately or as early as possible (for about 15 minutes, if possible) with soap or a cleansing agent and copious amounts of water. Apply an iodine-containing, or similarly viricidal, topical preparation to the wound. Administer Tetanus prophylaxis and measures to control bacterial infection, as indicated. Administer post-exposure antirabies vaccination with rabies vaccine in addition to administering Rabies Immune Globulin (RIG)

Treatment for a dog bite:

• Immediately wash the wound with soap and water for about 15 minutes.
• Apply an iodine-containing topical preparation to the wound.
• Administer Tetanus prophylaxis and measures to control bacterial infection, as indicated.
• Administer post-exposure antirabies vaccination with rabies vaccine in addition to administering Rabies Immune Globulin (RIG), if the person has not been previously vaccinated.
• Consult local or state public health officials if questions arise about the need for rabies prophylaxis 2, 3.

From the Research

Treatment of Dog Bites

• The treatment of dog bites often involves the use of antimicrobial agents to prevent infection, with studies suggesting that amoxicillin-clavulanic acid is an effective choice for moderate grade dog bite wounds 4.
• A randomized controlled trial found that the use of amoxicillin-clavulanic acid reduced the risk of infection in dog bite wounds, with an absolute reduction of 4% 5.
• The decision to use prophylactic antibiotics in dog bite wounds should be based on the risk of infection, with a cost model suggesting that antibiotics are cost-effective if the risk of wound infection is greater than 5% and antibiotics can decrease that risk by greater than 3% 5.

Antimicrobial Susceptibility

• Studies have identified common pathogens in dog bite wounds, including Staphylococcus pseudintermedius, Neisseria spp., Pasteurella multocida, and P. canis 4.
• The majority of gram-negative and gram-positive isolates were found to be susceptible to amoxicillin-clavulanic acid and enrofloxacin, with over 90% of isolates susceptible to amoxicillin-clavulanic acid and 96% of gram-negative and 86% of gram-positive isolates susceptible to enrofloxacin 4.

Wound Care

• The treatment of dog bite wounds also involves stabilization, wound care, and surgical debridement as needed, with the goal of promoting healing and preventing infection 4.
• The use of antimicrobial agents should be guided by the results of culture and susceptibility testing, with the goal of reducing the risk of infection and promoting antimicrobial stewardship 4.