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Recommended Therapy for Infections Following Animal or Human Bites[!^1]

Antimicrobial Agent by Type of Bite	Therapy Type
Antimicrobial Agent by Type of Bite	Oral	Intravenous	Comments
Animal bite
Amoxicillin-clavulanate	875/125 mg bid	…	Some gram-negative rods are resistant; misses MRSA
Ampicillin-sulbactam	…	1.5–3.0 g every 6–8 h	Some gram-negative rods are resistant; misses MRSA
Piperacillin-tazobactam	…	3.37 g every 6–8 h	Misses MRSA
Carbapenems		See individual info.	Misses MRSA
Doxycycline	100 mg bid	100 mg every 12 h	Excellent activity against Pasteurella multocida; some streptococci are resistant
Penicillin plus dicloxacillin	500 mg qid/500 mg qid	…
SMX-TMP	160–800 mg bid	5–10 mg/kg/day of TMP component	Good activity against aerobes; poor activity against anaerobes
Metronidazole	250–500 mg tid	500 mg every 8 h	Good activity against anaerobes; no activity against aerobes
Clindamycin	300 mg tid	600 mg every 6–8 h	Good activity against staphylococci, streptococci, and anaerobes; misses P. multocida
Second-generation cephalosporin			Good activity against P. multocida; misses anaerobes
Cefuroxime	500 mg bid	1 g every 12 h
Cefoxitin	…	1 g every 6–8 h
Third-generation cephalosporin
Ceftriaxone	…	1 g every 12 h
Cefotaxime	…	1–2 g every 6–8 h
Fluoroquinolones			Good activity against P. multocida; misses MRSA and some anaerobes
Ciproﬂoxacin	500–750 mg bid	400 mg every 12 h
Levofloxacin	750 mg daily	750 mg daily
Moxiﬂoxacin	400 mg daily	400 mg daily	Monotherapy; good for anaerobes also
Human bite
Amoxicillin-clavulanate	875/125 mg bid	…	Some gram-negative rods are resistant; misses MRSA
Ampicillin-sulbactam	…	1.5–3.0 g every 6 h	Some gram-negative rods are resistant; misses MRSA
Carbapenems			Misses MRSA
Doxycycline	100 mg bid	…	Good activity against Eikenella species, staphylococci, and anaerobes; some streptococci are resistant

Omitted

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