Biting Species

Commonly Isolated Pathogens

Preferred Antibiotic(s)^a

Alternative Agent(s) for Penicillin-Allergic Patients

Prophylaxis Advised for Early Uninfected Wounds

Other Considerations

Dog

Staphylococcus aureus, Pasteurella multocida, anaerobes, Capnocytophaga canimorsus

Amoxicillin/clavulanate (250–500 mg PO tid) or ampicillin/sulbactam (1.5–3.0 g IV q6h)

Clindamycin (150–300 mg PO qid) plus either TMP-SMX (1 double-strength tablet bid) or ciprofloxacin (500 mg PO bid)

Sometimes^b

Consider rabies prophylaxis.

Cat

P. multocida, S. aureus, anaerobes

Amoxicillin/clavulanate or ampicillin/sulbactam, as for dog bite

Clindamycin plus either TMP-SMX (as for dog bite) or a fluoroquinolone

Usually

Consider rabies prophylaxis. Carefully evaluate for joint or bone penetration.

Human,

• occlusional bite

Viridans streptococci, S. aureus, Haemophilus influenzae, anaerobes

Amoxicillin/clavulanate or ampicillin/sulbactam, as for dog bite

Erythromycin (500 mg PO qid) or a fluoroquinolone

Always

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Human,

• clenched-fist injury

As for occlusional plus Eikenella corrodens

Ampicillin/sulbactam, as for dog bite; or imipenem (500 mg q6h)

Cefoxitin^c

Always

Examine for tendon, nerve, or joint involvement.

Monkey

As for human bite

As for human bite

As for human bite

Always

For macaque monkeys, consider herpes B virus prophylaxis with acyclovir.

Biting Species

Commonly Isolated Pathogens

Preferred Antibiotic(s)^a

Alternative Agent(s) for Penicillin-Allergic Patients

Prophylaxis Advised for Early Uninfected Wounds

Other Considerations

Snake^d

Pseudomonas aeruginosa, Proteus spp., Bacteroides fragilis, Clostridium spp.

Ampicillin/sulbactam, as for dog bite

Clindamycin plus either TMP-SMX (as for dog bite) or a fluoroquinolone

Sometimes, especially for venomous snakebites

Antivenom for venomous snakebite

Rodent

Streptobacillus moniliformis, Leptospira spp., P. multocida

Penicillin VK (500 mg PO qid)

Doxycycline (100 mg PO bid)

Sometimes

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