Dog bites: Bacteriology, management, and prevention

Dog bites are among the most frequent causes of nonfatal injuries in the United States. Most dog bites involve children and young adults. Infected wounds are polymicrobial in nature; the most prevalent organisms are Pasteurella, streptococci, staphylococci, and Fusobacterium, Bacteroides, and Porphyromonas species. Musculoskeletal and neurovascular injuries, as well as systemic infections, can be complications of dog-bite wounds. Treatment includes thorough cleansing of the wound, with copious irrigation. Abscesses, when present, should undergo incision and drainage. Suitable antibiotics for the initial empiric and expectant therapy include amoxicillin-potassium clavulanate, a penicillin with a first generation cephalosporin, or clindamycin and a fluoroquinolone (eg, for patients allergic to penicillins). Preventive strategies should be aimed at public awareness of basic animal safety and responsible pet ownership.