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The following summarized guidelines for the evaluation and management of animal bites are prepared by our editorial team based on guidelines from the American Academy of Family Physicians (AAFP 2023; 2014), the Surgical Infection Society Europe (SIS-E/GAIS/WSES/WSIS/AAST 2023), the Surgical Infection Society Europe (SIS-E/WSES 2018), the Korean Society of Infectious Diseases (KSID/KDA/KOA/KSC 2017), and the Infectious Diseases Society of America (IDSA 2014).
Blood and wound cultures: as per KSID 2017 guidelines, consider obtaining blood culture, aspiration culture, or punch biopsy in patients with SSTI from an animal bite.
Antibiotic prophylaxis: as per AAFP 2023 guidelines, administer antibiotic prophylaxis in patients at increased risk of infection from dog or cat bites.
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Post-exposure rabies prophylaxis
Post-exposure tetanus prophylaxis
As per AAFP 2023 guidelines:
Consider performing primary closure at the time of injury for dog bite wounds at low risk of infection. Allow wounds at risk of infection to heal by secondary intention.
Refer patients with injuries to underlying structures (tendons, joints, bone) and injuries that could lead to scarring for possible surgical exploration and repair.
Pre-exposure rabies prophylaxis: consider administering pre-exposure rabies prophylaxis in persons at higher risk of rabies exposure and for international travelers to at-risk areas unlikely to get post-exposure prophylaxis within 24 hours of possible rabies exposure.