Human and Animal Bites

In the United States, nearly 56% of households owned a pet in 2011 according to the 2012 U.S. Pet Ownership & Demographics Sourcebook by the American Veterinary Medical Association. The survey also reports that approximately 70 million dogs and 74 million cats lived in households in the United States during the same year. (1)Human and animal bites are a frequent cause of primary care and emergency department visits for children. It is estimated that 250,000 human bites, 400,000 cat bites, and 4.5 million dog bites occur in the United States each year in both adults and children. (2) In the United States, approximately 10% of all human bites will become infected in a child with a bite wound. The infection rate of dog bites in children is 20%. Cat bite infection rates in children vary but can be up to 50%. Each type of bite wound has a predisposition for sex and/or age. Infected bite wounds manifest with swelling, erythema, and tenderness with or without drainage of the affected site and can lead to serious complications. Most animal bite wounds are polymicrobial in nature. Pasteurella species (spp.) is the most common organism isolated from both cat and dog bites. The microbiology of human bites consists of both aerobic and anaerobic bacteria.Basic medical management of bite wounds includes thorough cleansing and debridement. Irrigation, closure, and need to obtain culture depend on the type of bite wound, the appearance of the wound, the and timing of medical evaluation after the initial injury. Amoxicillin-clavulanate is the antibiotic of choice for prophylaxis and empirical therapy for children who are not allergic to penicillin. With most animal bites being preventable injuries, healthcare providers caring for children have an important role discussing pet safety with the child and the family.