At the request of a colleague who recently treated a patient bitten by a monkey, I am going to write about treatment and prophylaxis for animal bites.

First, a little BIT (get it?) about monkey bites. These are relatively rare in the US, primarily occurring in India or research labs. They have a high rate of infection and complications s/a osteomyelitis.

I have compiled a table on the treatment of these bites, adapted from Rosens.

 

SPECIES SUTURING PROPHYLAXIS? options for PPX ABX Options for INPT TX W ABX
DOGS the majority except hands and feet   augmentin, moxiflox, clinda + bactrim unasyn, timentin, zosyn, clinda+bactrim
CATS face only all wounds extending through epidermis augmentin, moxiflox, clinda + bactrim unasyn, timentin, zosyn, clinda+bactrim
HUMAN face only (within 24 hrs) all wounds extending through epidermis augmentin, moxiflox, cefoxitin, clinda + pcn or cipro unasyn, timentin, zosyn, imipenem, meropenem, ertapenem, clinda + pcn or cipro
MONKEY face only (within 24 hrs) all wounds extending through epidermis augmentin, moxiflox, cefoxitin, clinda + pcn or cipro unasyn, timentin, zosyn, imipenem, meropenem, ertapenem, clinda + pcn or cipro
RODENT all (but rarely needed) No not recommended
FERRET / PIG / HORSE / BEAR / BIG CATS face only all wounds extending through epidermis augmentin, moxiflox, clinda + bactrim unasyn, timentin, zosyn, clinda+bactrim

 

August 2022
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