Dog Bites

M Morgan in a BMJ Clinical review (BMJ 2007:334:413-417) is informative about the management of dog bites - not an uncommon problem in rural primary care.

I was surprised to learn that Pasteurella multocida infection can strike within 12 hours of a bite. I would always emphasise the need for good wound care and learnt that because of drug resistence P multocida does not respond to flucloxacillin/erythromycin - co-amoxiclav is to be preferred.

Antibiotic treatment should be preferred in immunocompromised patients and in those patients with a more than superficial wound. In established infection the duration of treatment depends on the type of infection. In primary care most establised infection will be cellulitic - 10-14 days treatment is adequate in these cases.