Spectrum: Local Antimicrobial Stewardship, for Island Health

Bite Wounds: Infection Rx

Consults

Infectious Disease consultation recommended for established infection.

Surgical specialist consultation as appropriate for debridement.

IV Regimen

Ceftriaxone 2g IV daily

AND

Metronidazole 500mg PO BID

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

Penicillin Allergy: Anaphylactic (IV or PO)

Ciprofloxacin 500mg PO BID

AND EITHER

Clindamycin 300-600mg PO QID

OR

Metronidazole 500mg PO BID

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.