Prevention of infection
To prevent infection in most cases, a careful wound toilet is enough. Regarding the indications for antibiotic therapy, there is no consensus. Drugs do not prevent the occurrence of infection in highly contaminated or improperly treated wounds, but many doctors prescribe antibiotics prophylactically with hand bites and with some other localizations. When bitten by dogs and a person for prevention and treatment, amoxicillin-lin + [clavulanic acid] is preferred 500-875 mg orally 2 times a day for 3 days (prophylaxis) or 5-7 days (treatment) for outpatients. For stationary patients, a valid empirical choice is ampicillin + [sulbactam] 1.5-3 g every 6 hours; it covers a-haemolytic streptococci, Staphylococcus aureus Eikenella corrodens, microorganisms most frequently sown by human bites, and various species of Pasteurella (P. Canis P. Multocida) and Capnocytophaga canimorsus, which are found when bitten by dogs. In the case of bites, cats are recommended for prevention and treatment of fluoroquinolones (eg, ciprofloxacin 500 mg orally for 5-7 days) due to the presence of P. Multocida. (Bartonella henselae is also transmitted through the bites of cats.) Alternative medications for patients with penicillin allergy may be clarithromycin 500 mg orally for 7-10 days or clindamycin 150-300 mg orally for 7-10 days. Bites of squirrels, gerbils, rabbits and guinea pigs lead to infection less often, but are subject to treatment similar to biting of cats.
The testimony to the prevention of viral hepatitis and HIV depends on the serological status of the victim and the attacker.
In case of infection, antibiotics are first prescribed empirically, depending on the characteristics of the bite, see above. Further treatment is based on the results of sowing from the wound. Wound sanitation, suturing, wetting and intravenous administration of antibiotics depend on the specificity of the infection and the clinical picture. Joint infection and osteomyelitis may require prolonged intravenous administration of antibiotics and orthopedic consultation.
Bites of monkeys (in the USA are found mainly among the employees of the vivariums) are associated with a low probability of a viral infection of the herpesvirus simiae, which causes vesicular lesions of the skin on the side of the bite. However, with these bites, the development of encephalitis is possible, often with a fatal outcome. Treatment is carried out by intravenous injection of acyclovir.