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Bite wounds

Content version
U-200.2
Updated
10/20/2025 - 13:03

Recommendations

≥ 18 years
Dosage Remarks
amoxicillin + clavulanic acid oral 500/125 mg three times daily for 5 days
≥ 18 years

Indications: Beta-lactam allergy
Dosage Remarks
doxycycline oral loading dose 200 mg, then 100 mg once daily for 5 days

Comments

Antibiotic prophylaxis is indicated in:

- human or cat bite;

- bite wounds to the hand/wrist, leg/foot, genitalia or face;

- deep puncture bites and crush bite wounds;

- patients in risk groups: 

  • Increased risk of a complicated course due to impaired immunity: for example untreated HIV infection, prior transplantation (organ/stem cell/bone marrow), (haematological) malignancy, asplenia, multiple sclerosis, medications (immunosuppressants, sometimes up to one year after use of cytotoxic chemotherapy).
  • Increased risk of endocarditis: history of endocarditis, prosthetic heart valves or congenital heart valve abnormalities (see NHG Treatment Guideline Endocarditis Prophylaxis).
  • Increased risk of infection of a joint prosthesis: a joint prosthesis < 2 years old, a joint prosthesis > 2 years old in combination with a history of an infected prosthesis, rheumatic joint disease or haemophilia.

Give tetanus prophylaxis for animal bites AND if the patient is not or incompletely vaccinated against tetanus or if there is impaired immunity: for example untreated HIV infection, prior transplantation (organ/stem cell/bone marrow), (haematological) malignancy, asplenia, multiple sclerosis, medications (immunosuppressants, sometimes up to one year after use of cytotoxic chemotherapy).