Predictors of infection from dog bite wounds: which patients may benefit from prophylactic antibioti
The Article: Predictors of infection from dog bite wounds: which patients may benefit from prophylactic antibiotics? Tabaka ME, et al. Emerg Med J 2015;32:860–863.
The Idea: To determine predictors of infection in dog bite wounds and which patients may benefit from prophylactic antibiotics.
The Study: A prospective multicenter observational study conducted over 4.5 years (2008-2013) in which dog bite victims were enrolled on initial emergency department visit. 18 patient, wound and treatment characteristics were recorded by the physician. Patients were then called at 30 days for follow up. Patients were considered to have an infection if they were subsequently treated by a physician with antibiotics for a wound infection.
The Findings: 495 patients were enrolled, of which 345 (69.7%) had complete follow up. 18 patients had infection noted on follow up. Of all variables analyzed, only puncture wounds were found to be significantly associated with infection. Though not significant, deep wounds and head and neck wounds trended toward having higher infection rates. This was also the case for wounds that were closed and patients treated with prophylactic antibiotics.
Takeaway: Puncture wounds are more likely to become infected and should get prophylactic antibiotics. In addition to this, wounds that are closed likely have higher infection rates. This study was limited in many ways. The authors do admit to many of the study’s limitations in the discussion. Most importantly it was observational, so there was no control. Patients received antibiotics based on physician discretion; so likely patients who seemed clinically more likely to have infection received antibiotics which very much limits the study’s ability to determine which characteristics would benefit from antibiotics.