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 |
