How to manage a rat bite?

From the Guidelines

To manage a roster bite, immediately clean the wound thoroughly with soap and water for at least 5 minutes to remove bacteria and debris, and apply an antiseptic solution like povidone-iodine or hydrogen peroxide to further disinfect the area. The wound should be covered with a clean bandage and changed daily or when it becomes wet or dirty. For pain relief, take over-the-counter medications such as acetaminophen (Tylenol) 500-1000mg every 6 hours or ibuprofen (Advil, Motrin) 400-600mg every 6-8 hours as needed. Monitor the wound for signs of infection including increased redness, swelling, warmth, pus, or red streaks extending from the wound. If these symptoms develop, or if you develop fever or the pain worsens significantly, seek medical attention promptly as you may need antibiotics, such as amoxicillin-clavulanate 875/125mg twice daily for 5-7 days, as recommended by the Infectious Diseases Society of America 1. People with diabetes, immune disorders, or deep puncture wounds should consult a healthcare provider regardless, as they may need prophylactic antibiotics. Tetanus vaccination should be updated if it's been more than 5 years since your last dose. Roster bites can introduce various bacteria from the animal's mouth into your tissue, which is why proper cleaning and monitoring are essential for preventing infection. It is also important to note that the management of animals that bite humans, as well as the control methods in wild animals, should be handled by local health departments and animal-control officials, as outlined in the guidelines for animal rabies prevention and control 1.

Some key points to consider when managing a roster bite include:

• Cleaning and disinfecting the wound promptly
• Monitoring for signs of infection
• Seeking medical attention if symptoms develop or worsen
• Updating tetanus vaccination if necessary
• Considering prophylactic antibiotics for high-risk individuals
• Handling animal bites and control methods in accordance with local guidelines and regulations.

Overall, the management of a roster bite requires prompt and proper wound care, monitoring for infection, and consideration of antibiotic prophylaxis and tetanus vaccination, as well as adherence to local guidelines for animal bites and control methods.

From the Research

Managing a Roster Bite

To manage a roster bite, several factors need to be considered, including the type of animal involved, the specific nature of the wound, and the circumstances of the attack.

• The management of bite injuries requires local wound care, antibiotics if appropriate, and prophylaxis against transmission of tetanus and viral pathogens, including Hepatitis B virus 2.
• Use of antibiotic prophylaxis is controversial, but most authorities agree that it is needed for hand wounds, puncture wounds, or "dirty" wounds of any type in any location 3.
• The choice of antibiotic is also controversial, but initial empirical treatment generally relies on broad-spectrum coverage 3.
• Rabies prophylaxis is indicated for bites by carnivorous wild animals, bats, and unvaccinated domestic animals 4, 3.
• Review of the patient's tetanus status is mandatory 4, 3.

Treatment Options

• Amoxicillin-clavulanic acid is an appropriate empirical antimicrobial choice for moderate dog bite wounds 5.
• The addition of enrofloxacin to amoxicillin-clavulanic acid may not be necessary in all cases, and its use should be guided by antimicrobial stewardship principles 5.
• Local wound care and surgical debridement may be necessary to promote healing and prevent infection 5.

Infection Risk

• Dog bites can result in bacterial infection of the wound, and may be associated with the transmission of viral pathogens, including blood-borne pathogens 2.
• The most common pathogens isolated from dog bite wounds include Staphylococcus pseudintermedius, Neisseria spp., Pasteurella multocida, and P. canis 5.
• Amoxicillin-clavulanic acid and enrofloxacin have been shown to be effective against these pathogens, with over 90% of gram-negative and gram-positive isolates susceptible to these antibiotics 5.