Dogs

Usual Pathogens
Polymicrobial:

Pasteurella spp
Streptococcus spp
Staphylococcus spp/MRSA
Anaerobes
Capnocytophaga spp
Eikenella spp
Bergeyella spp
Neisseria spp
Moraxella spp
Corynebacterium spp
Enterococcus spp
Bacillus spp

 

Rare:

Francisella tularensis

Leptospira spp

Leptotrichia spp

Blastomyces dermatitidis

Prophylaxis

- Ensure tetanus status up to date.

- Infection rate up to 20%. Prophylaxis within 12 hours of bite is recommended if:

  • moderate/severe (wound > 3 cm)
  • edema, pre-existing or resultant
  • puncture wounds
  • bone/joint involvement
  • injuries to hand, foot, face, genitalia
  • asplenic patients
  • advanced liver disease
  • immunocompromised
  • implants (e.g. prosthetic heart valves).
Empiric Therapy

Dose

Duration
Amoxicillin-clavulanate 875mg PO bid 3-5 days

 Penicillin/amoxicillin allergy

Empiric Therapy

Dose

Duration
Cefuroxime axetil 500mg PO bid 3-5 days
+    
Metronidazole 500mg PO bid  

Cefuroxime allergy

Empiric Therapy Dose Duration
[Doxycycline 100mg PO bid 3-5 days
+/-    
Metronidazole]  500mg PO bid  
or    
[TMP/SMX 1 DS tab PO bid 3-5 days
+    
Metronidazole]  500mg PO bid  

Treatment

Empiric Therapy

Dose

Duration
Amoxicillin-clavulanate 875mg PO bid 7-10 days

Penicillin/amoxicillin allergy

Empiric Therapy

Dose

Duration
Cefuroxime axetil 500mg PO bid 7-10 days
+    
Metronidazole 500mg PO bid  

Cefuroxime allergy

Empiric Therapy

Dose

Duration
[Doxycycline 100mg PO bid

7-10 days

+/-    
Metronidazole]  500mg PO bid  
or    
[TMP/SMX 1 DS tab PO bid 7-10 days
+    
Metronidazole]  500mg PO bid  

Moderate

Empiric Therapy

Dose

Duration
Ceftriaxone 2g IV daily

7-10 days

+    
Metronidazole 500mg PO bid  

Severe/Limb-threatening

Empiric Therapy

Dose

Duration
Piperacillin-tazobactam 3.375g IV q6h 10-14 days
Penicillin allergy    
Meropenem 500mg IV q6h 10-14 days