Child health update. Management of dog bites in children.
OBJECTIVE
A 4-year-old girl was playing with her neighbour's dog. The dog became excited and bit the girl on the forearm, leaving a puncture wound. As a result of the injury, she has presented to my office. Should she be treated with antibiotics? If so, which antibiotic should be used and for how long?


CONCLUSIONS
Initiation of prophylactic antibiotics is indicated if the dog bite has undergone primary closure; if there is a moderate or severe bite wound; for puncture wounds (especially if penetration of bone, tendon sheath, or joint), facial bites, bites to the hands or feet, or genital area bites; or wounds sustained by victims who are immunocompromised or asplenic. The first-line choice of antibiotic is amoxicillin-clavulanate. Appropriate tetanus and rabies prophylaxis as indicated should also be a part of caring for a patient who has sustained a dog bite, as well as local debridement and thorough cleaning of the wound.
BC Children's Hospital, Department of Pediatrics, Room K4-226, Ambulatory Care Bldg, 4480 Oak St, Vancouver, BC V6H 3V4.
Vikram
V
Sabhaney
Ran D
RD
Goldman
D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001733:Bites and Stings / Q000150:complications / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004285:Dogs; D005260:Female; D006801:Humans; D008297:Male; D014946:Wound Infection / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D019980:Amoxicillin-Potassium Clavulanate Combination