title: Dog bite injuries: primary and secondary emergency department presentations--a retrospective cohort study.
abstract: Dog bites in humans are a complex problem, embracing both public health and animal welfare. The primary aim of this study is to examine primary and secondary presentations related to dog bite injuries in adults.
  
  
  METHODS
  We retrospectively assessed all adult patients admitted with a dog bite injury to the Emergency Department of Bern University Hospital.
  
  
  RESULTS
  A total of 431 patients were eligible for the study. Forty-nine (11.4%) of all patients were admitted with secondary presentations. Bites to the hands were most common (177, 41.1%). All patients (47, 100%) with secondary presentations were admitted because of signs of infection. The median time since the dog bite was 3.8 days (SD 3.9, range 1-21). Thirty-one patients had already been treated with antibiotic; coamoxicillin was the most common primary antibiotic therapy (27/47 patients, 57.4%). Patients with injuries to the hand were at increased risk of secondary presentations (OR 2.08, 95% CI 1.21-3.55, P < 0.006).
  
  
  CONCLUSIONS
  Dog bite injuries to the hands are a major problem. They often lead to infectious complications. Immediate antibiotic therapy should carefully be evaluated for each patient.
authors.affiliation: Department of General Internal Medicine, Bern University Hospital, University of Bern, 3010 Bern, Switzerland ; Department of Emergency Medicine, Bern University Hospital, University of Bern, 3010 Bern, Switzerland.
authors.forename: Carmen A
authors.initials: CA
authors.lastname: Pfortmueller
authors.forename: Anastasios
authors.initials: A
authors.lastname: Efeoglou
authors.forename: Hansjakob
authors.initials: H
authors.lastname: Furrer
authors.forename: Aristomenis K
authors.initials: AK
authors.lastname: Exadaktylos
mesh_terms: D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001733:Bites and Stings / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology*; D015331:Cohort Studies; D004285:Dogs; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D016017:Odds Ratio; D012189:Retrospective Studies; D013557:Switzerland / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents