Human and animal bites: Acute care and follow-up

Ralph Riviello, Kenneth G. Lavelle

Research output: Contribution to journalReview articlepeer-review


During the initial evaluation, obtain a complete history of the incident and ask about drug allergies, previous tetanus immunization, and conditions such as diabetes that might predispose the patient to infection. Give a tetanus-diphtheria toxoid booster dose to bite victims who have not been vaccinated within the past 5 years. If a patient presents more than 12 to 24 hours after a bite, leave the wound open. In addition, primary closure is not recommended for hand wounds or cat bites. Other fresh wounds can be sutured after devitalized tissue has been debrided. Prescribe a 3- to 5-day regimen of prophylactic antibiotic therapy for patients with high-risk wounds (bites on the hand or genital region, human or cat bites, and crush or puncture injuries) and those with immunosuppressive conditions. amoxicillin-clavulanate is the first choice for prophylaxis and empiric treatment of infection; alternatives are second-generation cephalosporins, doxycycline, clidamycin plus trimethoprim-sulfameth-oxazole, and clindamycin plus a fluoroquinolone. In hunan bite wounds, HIV post-exposure prophylaxis (PEP) is indicated when either participant is HIV-positive or at high risk; when one of the involved is infected with hapatitis B virus, PEP is given to the noninfected person, if not previously vaccinated.

Original languageEnglish (US)
Pages (from-to)1091-1100
Number of pages10
Issue number10
StatePublished - Sep 1 2005
Externally publishedYes


  • Antibiotic prophylaxis
  • Hepatitis B
  • Human bites
  • Rabies
  • Rabies vaccines
  • Tetanus
  • Toxoids
  • Viral hepatitis vaccines
  • Wound infection
  • Wounds and injuries

ASJC Scopus subject areas

  • Medicine(all)


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