Spectrum: Local Antimicrobial Stewardship, for Prisma Health Children’s Hospital-Midlands

Dog or Cat Bite

Common Pathogens

Pasturella

Anaerobes

Recommendations

Update tetanus vaccine if necessary

Post exposure rabies prophylaxis if indicated

Initial Empiric Treatment

Amoxicillin/Clavulanate (Augmentin®) PO

OR

Ampicillin/sulbactam (Unasyn®) IV

If not tolerating PO

Alternative PO Regimen

SMX/TMP PO

AND

Metronidazole PO

Alternative IV Regimen

Ceftriaxone IV

AND

Metronidazole IV

Use IV regimen if patient is not tolerating PO

De-escalation

De-escalate to narrowest spectrum PO antibiotic based on susceptibilities

Duration

5 days