Is injection of contaminated animal bite wounds with rabies immune globulin a safe practice?
In Asia, it is still controversial whether it is safe to inject a contaminated animal bite wound with a foreign protein such as equine or human rabies immune globulin, even though this is recommended by the World Health Organization. A prospective study of 114 severe animal bite wounds which were injected with equine or human rabies immune globulin revealed an overall incidence of gross infection of 11.4%. No matched control group of patients bitten by animals whose wounds were not injected with immune globulin could be studied in this environment with a high prevalence of canine rabies. The incidence of wound infection in lacerations inflicted by sharp objects and sutured under local anaesthesia was therefore studied prospectively in 100 Thai patients from a similar socio-economic milieu; it was found to be 13%. Wound infection was more common in animal bites and lacerations of the lower extremities. It is concluded that injecting a properly cleansed bite wound with equine or human rabies immune globulin is a safe practice and should be performed whenever there is a possibility that the biting animal might have rabies.
Wilde
H
H
WHO Collaborating Centre for Rabies Research on Pathogenesis and Prevention, Queen Saovabha Memorial Institute, Bangkok, Thailand.
Bhanganada
K
K
Chutivongse
S
S
Siakasem
A
A
Boonchai
W
W
Supich
C
C
D000818:Animals; D001733:Bites and Stings / Q000628:therapy*; D002415:Cats; D004285:Dogs; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D015552:Injections, Intralesional / Q000009:adverse effects; D011446:Prospective Studies; D011818:Rabies / Q000517:prevention & control*; D014946:Wound Infection / Q000517:prevention & control*
D016756:Immunoglobulins, Intravenous