IDSA (Infectious Disease Society of America) recommends the use of systemic antibiotics in all human bites. However, many large clinical trials suggest that systemic antibiotics may not be started if wound is just limited to epidermal layers and wound is not looking contaminated.
Wounds should be given primary care by washing with soap and water and preferably be left for open care. Routine Tetanus prophylaxis should be checked and administered as indicated in other wounds.
Cephalexin, which is commonly used for skin and soft-tissue infections, is ineffective against Eikenella corrodens, an important pathogen(gram negative bacillus) in infected human bites and most isolates are found to be resistant to clindamycin, penicillinase-resistant semisynthetic penicillins, macrolides, and aminoglycosides
First Choice of antibiotics should include amoxicillin/clavulanate or ampicillin/sulbactam plus Metronidazole.
In case of Penicillin allergic patients, Trimethoprim-sulfamethoxazole (TMP-SMZ) or a quinolone such as levofloxacin or moxifloxacin in addition to clindamycin is an acceptable alternative in the penicillin-allergic patient.
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