Dog | Staphylococcus aureus, Pasteurella multocida, anaerobes, Capnocytophaga canimorsus | Amoxicillin/clavulanate (250–500 mg PO tid) or ampicillin/sulbactam (1.5–3.0 g IV q6h) | Clindamycin (150–300 mg PO qid) plus either TMP-SMX (1 DS tablet PO bid) or ciprofloxacin (500 mg PO bid) | Sometimesb | Consider rabies prophylaxis. |
Cat | P. multocida, S. aureus, anaerobes | Amoxicillin/clavulanate or ampicillin/sulbactam as above | Clindamycin plus TMP-SMX as above or a fluoroquinolone | Usually | Consider rabies prophylaxis. Carefully evaluate for joint/bone penetration. |
Human, occlusional | Viridans streptococci, S. aureus, Haemophilus influenzae, anaerobes | Amoxicillin/clavulanate or ampicillin/sulbactam as above | Erythromycin (500 mg PO qid) or a fluoroquinolone | Always | |
Human, clenched-fist | As for occlusional, plus Eikenella corrodens | Ampicillin/sulbactam as above or imipenem (500 mg q6h) | Cefoxitinc | Always | Examine for tendon, nerve, or joint involvement. |
Monkey | As for human bite | As for human bite | As for human bite | Always | For macaque monkeys, consider B virus prophylaxis with acyclovir. |
Snake | Pseudomonas aeruginosa, Proteus spp., Bacteroides fragilis, Clostridium spp. | Ampicillin/sulbactam as above | Clindamycin plus TMP-SMX as above or a fluoroquinolone | Sometimes, especially with venomous snakes | Administer antivenin for venomous snakebite. |
Rodent | Streptobacillus moniliformis, Leptospira spp., P. multocida | Penicillin VK (500 mg PO qid) | Doxycycline (100 mg PO bid) | Sometimes | |
Aquatic animal (alligator, piranha, shark, moray eel, barracuda) | Aeromonas hydrophila, marine Vibrio spp. (Vibrio vulnificus) | Third-generation cephalosporin (e.g., ceftriaxone, 1 g IV q24h) plus doxycycline (100 mg PO bid) | Clindamycin plus levofloxacin (750 mg PO qd) plus doxycycline | Always | Obtain prompt surgical consultation, as risk for necrotizing infection is high with Aeromonas and Vibrio spp. |