Sandbox/Alejandro

Adults   ▸  Human Bite   ▸  Dog Bite   ▸  Cat Bite   ▸  Pig Bite   ▸  Monkey Bite   ▸  Rat Bite

Human Bite (Adults) Preferred Regimen ▸ Ampicillin sulbactam 1.5 g IV q6h OR ▸ Cefoxitin 2 gm IV q8h OR ▸ Ticarcillin clavulanate 3.1 g IV q6h OR ▸ Piperacillin-tazobactam 3.375 g IV q6-8h Alternative Regimen (beta-lactam allergy) ▸ Clindamycin 300 mg PO q8h PLUS ▸ Ciprofloxacin 500-750 mg IV q12h OR ▸ Moxifloxacin 400 mg IV q24h OR ▸ TMP-SMX 160/800 mg q12h Dog Bite (Adults) Preferred Regimen ▸ Amoxicillin-clavulanate 500-875/125 PO q8-12h Alternative Regimen (beta-lactam allergy) ▸ Clindamycin 300 mg PO q8h PLUS ▸ Ciprofloxacin 500-750 mg IV q12h OR ▸ Moxifloxacin 400 mg IV q24h OR ▸ Gatifloxacin 400 mg q24h Cat Bite (Adults) Preferred Regimen ▸ Amoxicillin-clavulanate 500-875/125 PO q8-12h Alternative Regimen (beta-lactam allergy) ▸ Cefuroxime 500 mg q12h OR ▸ Doxycycline 100 mg q12h Pig (Swine) Bite (Adults) Preferred Regimen ▸ Amoxicillin-clavulanate 875/125 mg orally q12h X 5 days Alternative Regimen ▸ Ampicillin sulbactam 1.5 to 3 g IV q6-8h OR ▸ Imipenem cilastatin 1 g IV q6-8h OR ▸ Ceftriaxone 1 g q12 h OR ▸ Cefotaxime 2 g q6 h High risk bites (deep bites, symptomatic animals) Preferred Regimen (without CNS symptoms) ▸ Acyclovir 12.5–15 mg per kg IV q8h OR ▸ Ganciclovir 5 mg per kg IV q12h Preferred Regimen (with CNS symptoms) ▸ Ganciclovir 5 mg per kg IV q12h Uncomplicated Preferred Regimen ▸ Amoxicillin-clavulanate 875/125 mg orally q12h Alternative Regimen (beta-lactam allergy) ▸ Doxycycline 100 mg orally q12h Rat bite fever Preferred Regimen ▸ Penicillin G benzathine 600,000 to 1,000,000 units/day IM X 10-14 days OR ▸ Tetracycline 250 to 500 mg orally q6h Alternative Regimen ▸ Streptomycin 15 mg/kg/day IM in a single dose or in 2 divided doses X 10-14 days

Children   ▸  Human Bite   ▸  Dog Bite   ▸  Cat Bite   ▸  Pig Bite   ▸  Monkey Bite   ▸  Rat Bite

Human Bite (Children) Preferred Regimen ▸ Ampicillin sulbactam 100 to 300 mg/kg/day IV q6h OR ▸ Cefoxitin 80 to 160 mg/kg/day IV in 4 divided doses OR ▸ Ertapenem (3months - 12years) 15 mg/kg IV twice daily (maximum 1 g/day) OR Ertapenem (>13years) 1 g IV once daily Dog Bite (Children) Preferred Regimen ▸ Ampicillin sulbactam 100 to 300 mg/kg/day IV q6h OR ▸ Cefoxitin 80 to 160 mg/kg/day IV in 4 divided doses OR ▸ Ertapenem (3months - 12years) 15 mg/kg IV twice daily (maximum 1 g/day) OR Ertapenem (>13years) 1 g IV once daily Cat Bite (Children) Preferred Regimen ▸ [[ Pig (Swine) Bite (Children) Preferred Regimen ▸ Amoxicillin-clavulanate 875/125 mg orally q12h X 5 days Alternative Regimen ▸ Ampicillin sulbactam 100 to 300 mg/kg/day IV q6h OR ▸ Imipenem cilastatin 1 g IV q6-8h OR ▸ Cephalosporin High risk bites (deep bites, symptomatic animals) Preferred Regimen (without CNS symptoms) ▸ Acyclovir 12.5–15 mg per kg IV q8h OR ▸ Ganciclovir 5 mg per kg IV q12h Preferred Regimen (with CNS symptoms) ▸ Ganciclovir 5 mg per kg IV q12h Early (not yet infected) Preferred Regimen ▸ Amoxicillin-clavulanate 45 mg/kg/day orally in two divided doses X 3-7 days Alternative Regimen ▸ Cefuroxime 10 to 15 mg/kg orally q12h Rat bite fever Preferred Regimen ▸ Penicillin G benzathine 25,000 to 50,000 units/day IM X 10-14 days OR ▸ Tetracycline (>8 years) 25 to 50 mg/kg/day orally in 4 divided doses X 10-14 days Alternative Regimen ▸ Streptomycin 15 mg/kg/day IM in a single dose or in 2 divided doses X 10-14 days