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Rationale:
- Long, sharp teeth of cats may penetrate deep into bone, joint space, or tendon sheaths. Progression of infection, despite
antibiotic treatment, suggests a deeper process that may require surgical drainage.
- Penicillin is active against Pasteurella and Capnocytophaga, but has variable activity against S. intermedius and no activity against S. aureus. Pasteurella is resistant to oxacillin, nafcillin, and dicloxacillin, and first-generation cephalosporins.
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Evidence:
- Infections from animal bites are commonly caused by a mixture of bacteria including Pasteurella multocida, S. intermedius, anaerobes, and S. aureus. Amipicillin/sulbactam and amoxicillin/clavulanate have good activity against most of these pathogens (115; 17; 116; 15; 16).
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Comments:
- Capnocytophaga canimorsus, a rare pathogen from dog bites causing a severe sepsis syndrome with disseminated intravascular coagulation, is also well
covered by these antimicrobials.
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Dennis L. Stevens, PhD, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Lawrence J. Eron, MD, FACP has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted (c) 2008 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Cellulitis and Soft Tissue Infections
> Drug Therapy
