What antibiotics are recommended for a puncture wound caused by a fish fin?

From the Guidelines

Antibiotics for Fish Fin Injuries For a puncture wound caused by a fish fin, amoxicillin-clavulanate is recommended as the first-line antibiotic treatment 1.

Recommended Antibiotics

• Amoxicillin-clavulanate: 875/125 mg orally twice daily 1
• Alternatively, doxycycline may be considered, especially for its excellent activity against certain bacteria, at a dose of 100 mg orally twice daily 1

Important Considerations

• Antibiotic therapy should only be initiated under the guidance of a healthcare professional, as improper use can lead to antibiotic resistance and other adverse effects.
• The choice of antibiotic may depend on the severity of the injury, the presence of any underlying medical conditions, and the risk of infection.
• It is essential to note that fish fin injuries can be prone to infection with various bacteria, including Streptococcus and Staphylococcus species, and anaerobic organisms 1.
• Topical antibiotics such as Neosporin or Bacitracin may also be applied directly to the affected area, but their use should be guided by a healthcare professional.
• The duration of antibiotic treatment is typically 7-10 days, but this may vary depending on the severity of the injury and the clinical response to treatment 1.

From the Research

Antibiotic Recommendations for Puncture Wounds Caused by Fish Fins

• The study 2 found that ceftazidime and doxycycline were administered to 68.8% and 96.7% of cases, respectively, for hand infections following penetrating fish fins or bones injuries.
• Another study 3 suggested that amoxicillin and clavulanic acid is an adequate first-line antibiotic for fish spike injuries, but flucloxacillin may be more appropriate given that most bacteria were from patients' own skin flora.
• The study 4 recommended that antibiotic selection should be tailored to eradicate the causative organism, and a foreign body should always be sought even if not present on the radiograph.

Considerations for Antibiotic Resistance

• The review article 5 highlighted the issue of antibiotic resistance in the finfish aquaculture industry, which may impact the effectiveness of antibiotics in treating puncture wounds caused by fish fins.
• The study 3 found that 12% of patients with fish spike injuries grew clinically relevant bacteria resistant to amoxicillin and clavulanic acid, including methicillin-resistant Staphylococcus aureus and Enterobacter cloacae.

Clinical Characteristics and Disease Course

• The study 2 described the clinical characteristics and disease course of hand infections following penetrating fish fins or bones injuries, including the presence of fever and predisposing conditions as risk factors for a complicated hospitalization course.
• The study 6 reviewed the literature on catfishing injuries, including the types of injuries and subsequent morbidity associated with catfish encounters, and highlighted the importance of considering the potential for foreign body embedment and delayed symptoms.