Spectrum: Local Antimicrobial Stewardship, for AHS Calgary Zone

Bite wounds: Infection Rx

Consults

Infectious Disease consultation recommended for established infection

Surgical specialist consultation as appropriate for debridement

Notes

Cultures (preferably tissue) must be sent to guide treatment of these microbiologically complex infections

Duration of Therapy

5-10 days tailored to clinical response

Longer duration for bacteremia or infection of bone/joint/tendon sheath - discuss with Infectious Disease

IV Regimen

Ceftriaxone 2g IV daily

AND

Metronidazole 500mg PO TID

OR

Piperacillin-Tazobactam 3.375g IV q6h

Oral Regimen

Amoxicillin/Clavulanic Acid 875mg PO BID or 500mg PO TID

Penicillin Allergy

Non-anaphylactic: use Ceftriaxone and Metronidazole as above for IV

Anaphylactic (IV or PO):

Ciprofloxacin 500mg PO BID

AND EITHER

Clindamycin 300-600mg PO QID

OR

Metronidazole 500mg PO TID