Spectrum: Local Antimicrobial Stewardship, for Alberta Children's Hospital

Human Bite

Note

Increased prevalence of community acquired MRSA. Attempt cultures if feasible.

Bacterial Pathogen

Viridans streptococci

Staphylococcus aureus

Staphylococcus epidermidis

Corynebacterium sp.

Eikenella corrodens

Anaerobes

Duration of Therapy

10 days

First Line Therapy

Amoxicillin/Clavulanic acid: 40-50 mg/kg per day divided tid

Alternatives (in Order)

Clindamycin 10-40 mg/kg per day divided tid-qid

AND

Cotrimoxazole 6-12 mg TMP/kg per day divided bid

OR

Ceftriaxone 50 mg/kg per day IM/IV once a day

AND

Metronidazole 22.5-40 mg/kg/day IV divided q8h