Reality bites: human bites and infection prevention

Our posting has been slow, and will continue to be for a short time due to clinical service and travel schedules. However, I thought now was a good time to review the management of human bite wounds. There are summaries in Medscape and UpToDate, a literature review in this trauma journal, and even national (UK) guidance on management. There is not uniformity in the literature about the need for antibiotic prophylaxis, though most would use something like amoxicillin-clavulanate if the bite punctures the skin, particularly if it involves the hand or another joint capsule or tendon. Remember also to assess need for a tetanus booster, and to evaluate for bloodborne pathogen exposure. Rabies in humans remains rare in most parts of the world, and in the most recent case I’m sure there will be at least a 10-day observation period for the biter.